| NPI | 1922089671 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: NJ 34309) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NJ 34309) |
| 207RG0300X Internal Medicine Geriatric Medicine (Licence: NJ 34309) | |
| Enumeration Date | 2005-11-09 |
| Last Update Date | 2008-07-18 |