| 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 |