| NPI | 1932133642 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: KY 40483) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NJ 25MA06013400) |
| Enumeration Date | 2006-07-10 |
| Last Update Date | 2020-12-03 |