| NPI | 1124013636 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: IL 036-082132) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: MO 109425) |
| Enumeration Date | 2005-09-12 |
| Last Update Date | 2022-07-21 |