| NPI | 1770791923 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: NJ 25MA10836900) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: DC MD036555) |
| 207R00000X Internal Medicine (Licence: PA MD430296) | |
| Enumeration Date | 2007-05-20 |
| Last Update Date | 2024-10-09 |