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 |