| NPI | 1063893733 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: NH 35101) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 036150023) |
| 207R00000X Internal Medicine (Licence: MI 4301108088) | |
| Enumeration Date | 2015-06-17 |
| Last Update Date | 2025-08-15 |