| NPI | 1619957107 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: GA 067892) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WI 46290-020) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: IL 036.130180) | |
| Enumeration Date | 2006-01-19 |
| Last Update Date | 2014-09-09 |