| NPI | 1003083627 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: MI 4301100025) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 036120897) |
| Enumeration Date | 2008-05-13 |
| Last Update Date | 2021-05-26 |