| NPI | 1770655060 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: NJ MA57880) |
| Additional Taxonomies | 207RG0100X Internal Medicine Gastroenterology (Licence: PA MD017976) |
| Enumeration Date | 2006-11-14 |
| Last Update Date | 2016-04-25 |