| NPI | 1811995426 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: IL 036062964) |
| Additional Taxonomies | 174400000X Specialist (Licence: IL 036062964) |
| Enumeration Date | 2005-07-08 |
| Last Update Date | 2016-11-21 |