| NPI | 1518492602 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: NJ 25MA12886900) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 331766) |
| Enumeration Date | 2017-04-26 |
| Last Update Date | 2026-06-23 |