| NPI | 1104189661 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: IL 0361388069) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125:061693) |
| Enumeration Date | 2012-06-20 |
| Last Update Date | 2023-08-04 |