| NPI | 1922158591 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: NJ 25MB04638900) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NJ 25MB04638900) |
| Enumeration Date | 2007-01-12 |
| Last Update Date | 2023-12-26 |