| NPI | 1912430653 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: NJ 25MA12547800) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: NY 329450) |
| Enumeration Date | 2017-04-10 |
| Last Update Date | 2025-08-13 |