| NPI | 1881027662 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: IL 036174247) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: WV 29822) |
| Enumeration Date | 2013-08-15 |
| Last Update Date | 2025-09-17 |