| NPI | 1659697290 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: NJ 25MA09773600) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT196991) |
| 207RG0100X Internal Medicine Gastroenterology (Licence: PA MD449091) | |
| Enumeration Date | 2010-04-07 |
| Last Update Date | 2023-10-29 |