| NPI | 1457542920 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MI 4301090067) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 036138923) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: IL 036138923) | |
| Enumeration Date | 2007-08-08 |
| Last Update Date | 2025-06-02 |