| NPI | 1851852628 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: MI 5315240788)  | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 036-158337)  | 
| Enumeration Date | 2019-03-26 | 
| Last Update Date | 2023-08-03 |