| NPI | 1760611776 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: WV 29606) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: IL 036130658) |
| Enumeration Date | 2009-07-11 |
| Last Update Date | 2020-07-15 |