| NPI | 1568641058 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: NJ 25MA09096400) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT188777) |
| 207RG0100X Internal Medicine Gastroenterology (Licence: NY 252443) | |
| Enumeration Date | 2007-10-31 |
| Last Update Date | 2015-05-21 |