| NPI | 1265013601 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: FL 173921) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: IL 036170456) |
| Enumeration Date | 2021-04-17 |
| Last Update Date | 2025-05-05 |