| NPI | 1861422586 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: ME MD22765) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: NJ 25MA07878000) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: SC 85891) | |
| Enumeration Date | 2006-07-05 |
| Last Update Date | 2024-04-18 |