| NPI | 1902062037 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: IL 036.128310) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 036.128310) |
| Enumeration Date | 2008-07-29 |
| Last Update Date | 2015-06-30 |