| NPI | 1205329489 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: IL 125.072559) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: KY 59282) |
| Enumeration Date | 2018-06-12 |
| Last Update Date | 2024-07-19 |