| NPI | 1578123246 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: NJ 25MA12618700) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT217541) |
| Enumeration Date | 2019-06-16 |
| Last Update Date | 2025-06-30 |