| NPI | 1770044919 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: IL 036169929) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125.074614) |
| Enumeration Date | 2019-03-29 |
| Last Update Date | 2025-07-24 |