| NPI | 1619963063 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: IL 036100455) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: MO MO110985) |
| Enumeration Date | 2005-09-21 |
| Last Update Date | 2021-03-12 |