| NPI | 1972701563 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: NJ 25MA03805900) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: NY 147756) |
| Enumeration Date | 2007-07-05 |
| Last Update Date | 2021-06-22 |