| NPI | 1821152067 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: IL 036169528) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: WI 18229) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: VA 0102201636) | |
| Enumeration Date | 2006-12-21 |
| Last Update Date | 2025-01-16 |