| NPI | 1679033815 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: IL 036-178870) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NH 207R00000X) |
| Enumeration Date | 2019-03-22 |
| Last Update Date | 2026-08-20 |