NPI | 1679589121 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: NJ 25MA09823400) |
Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: PA MD-029154E) |
Enumeration Date | 2006-08-01 |
Last Update Date | 2021-07-23 |