| NPI | 1700142395 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: IL 036145318) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: DC MD043311) |
| Enumeration Date | 2012-04-09 |
| Last Update Date | 2021-05-05 |