| NPI | 1003048976 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: WI 60377) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: OH 34.012657) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: MO 2016007352) | |
| Enumeration Date | 2009-08-11 |
| Last Update Date | 2020-06-16 |