| NPI | 1780171066 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: NJ 25MA12275800) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT215817) |
| Enumeration Date | 2018-04-22 |
| Last Update Date | 2026-05-05 |