| NPI | 1629500053 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: IL 036.156349) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: DC DO034916) |
| Enumeration Date | 2017-04-03 |
| Last Update Date | 2021-04-12 |