| NPI | 1780740860 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: NY 165502) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: NJ MA46448) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: NJ 25MA04644800) | |
| Enumeration Date | 2006-12-31 |
| Last Update Date | 2025-07-16 |