| NPI | 1952311367 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: CA G87813) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: NJ 32414) |
| Enumeration Date | 2006-08-08 |
| Last Update Date | 2007-07-08 |