| NPI | 1902139173 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: IL 036129287) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 036129287) |
| Enumeration Date | 2009-09-04 |
| Last Update Date | 2016-06-01 |