| NPI | 1538114566 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: FL ME146269) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: NJ MA49072) |
| Enumeration Date | 2006-05-25 |
| Last Update Date | 2023-01-30 |