| NPI | 1669902482 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: IL 036.160791) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125.070912) |
| Enumeration Date | 2017-06-14 |
| Last Update Date | 2023-08-30 |