| NPI | 1497812101 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: NJ 25MA08422400) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 223289) |
| Enumeration Date | 2007-01-02 |
| Last Update Date | 2012-06-13 |