| NPI | 1104159383 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: CA A113069) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: IL 036169574) |
| Enumeration Date | 2009-09-07 |
| Last Update Date | 2026-03-09 |