| NPI | 1679759906 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: GA 67355) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 25050053) |
| Enumeration Date | 2008-01-16 |
| Last Update Date | 2015-09-23 |