| NPI | 1215377486 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: FL OS17914) |
| Additional Taxonomies | 207RG0100X Internal Medicine Gastroenterology (Licence: IL 036148712) |
| Enumeration Date | 2013-07-02 |
| Last Update Date | 2021-10-27 |