| NPI | 1679147201 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: NY 317300) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: IL 125.077305) |
| Enumeration Date | 2021-05-18 |
| Last Update Date | 2023-09-04 |