| NPI | 1487654349 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: NJ 25MA07866400) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: NJ MA07866400) |
| Enumeration Date | 2005-07-21 |
| Last Update Date | 2010-07-20 |