| NPI | 1104269679 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: IL 036179304) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: OH 35127799) |
| 207R00000X Internal Medicine (Licence: IL 036179304) | |
| Enumeration Date | 2013-04-15 |
| Last Update Date | 2026-06-24 |