| NPI | 1891734828 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: CA C54247) |
| Additional Taxonomies | 207RG0100X Internal Medicine Gastroenterology (Licence: NJ MA64612) |
| Enumeration Date | 2006-06-05 |
| Last Update Date | 2023-01-12 |