| NPI | 1679570006 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NJ 25MA05933800) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: NJ 25MA05933800) |
| Enumeration Date | 2005-06-30 |
| Last Update Date | 2017-12-14 |