| NPI | 1982653671 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: SC 88567) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: NJ 25MA04822100) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: FL ME126389) | |
| Enumeration Date | 2006-05-09 |
| Last Update Date | 2023-03-07 |