NPI | 1972563740 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: NJ 25MA03565800) |
Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: NJ 03565800) |
207RG0100X Internal Medicine, Gastroenterology (Licence: NJ MA03565800) | |
Enumeration Date | 2006-03-25 |
Last Update Date | 2011-11-10 |