| NPI | 1619223708 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: WI 63625-20) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125.060781) |
| Enumeration Date | 2012-07-26 |
| Last Update Date | 2019-07-08 |