| NPI | 1902813272 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: NJ 25MA06961100) |
| Additional Taxonomies | 174400000X Specialist (Licence: NJ MA06961100) |
| Enumeration Date | 2006-08-01 |
| Last Update Date | 2017-10-30 |