| NPI | 1053356840 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: MO 33925) | 
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: IL 036043679) | 
| Enumeration Date | 2006-06-17 | 
| Last Update Date | 2024-01-03 |