| NPI | 1730148495 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: TX K7479) |
| Additional Taxonomies | 174400000X Specialist (Licence: IL 036-107804) |
| 174400000X Specialist (Licence: NC 2001-1396) | |
| Enumeration Date | 2006-03-21 |
| Last Update Date | 2023-09-26 |