| NPI | 1629204771 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: NJ 25MA09901400) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 241335) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: FL TRN17459) | |
| Enumeration Date | 2009-06-03 |
| Last Update Date | 2016-06-20 |