| NPI | 1265765457 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: AZ 66876) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125054896) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: IA 40071) | |
| Enumeration Date | 2009-09-07 |
| Last Update Date | 2022-11-04 |