| NPI | 1700176088 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: FL ME149118) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME149118) |
| 207R00000X Internal Medicine (Licence: ME MD23203) | |
| 207R00000X Internal Medicine (Licence: IL 036126159) | |
| Enumeration Date | 2011-04-07 |
| Last Update Date | 2023-01-23 |