| NPI | 1891976981 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: IL 036126494) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125-053381) |
| Enumeration Date | 2007-11-17 |
| Last Update Date | 2018-03-17 |