| NPI | 1700381472 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: MD D0103478) |
| Additional Taxonomies | 207RG0100X Internal Medicine Gastroenterology (Licence: IL 036.160514) |
| Enumeration Date | 2018-03-26 |
| Last Update Date | 2025-06-30 |