| NPI | 1790247492 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: IL 036.160069) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: NY 336079) |
| Enumeration Date | 2019-04-02 |
| Last Update Date | 2026-07-31 |