| NPI | 1871745042 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: NJ 25MA08351200) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NJ 25MA08351200) |
| Enumeration Date | 2008-10-19 |
| Last Update Date | 2021-04-26 |