| NPI | 1912906462 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: AZ 58745) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: OH 35.143072) |
| 174400000X Specialist (Licence: IL 036108726) | |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: MI 4301502257) | |
| Enumeration Date | 2005-07-18 |
| Last Update Date | 2023-08-08 |