| NPI | 1790765576 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: NJ MA06946500) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NJ MA06946500) |
| Enumeration Date | 2006-01-18 |
| Last Update Date | 2008-04-23 |