NPI | 1639141054 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: NJ NJ36940) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: NJ NJ36940) |
207RG0100X Internal Medicine, Gastroenterology (Licence: NY 140230) | |
207RG0100X Internal Medicine, Gastroenterology (Licence: NJ 25MA03694000) | |
Enumeration Date | 2006-02-02 |
Last Update Date | 2023-11-23 |