| NPI | 1942439336 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: TX T9412) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: MI 4301094929) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: IL 036174125) | |
| Enumeration Date | 2009-07-07 |
| Last Update Date | 2025-07-22 |