| NPI | 1003177304 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: MN 76613) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: OH 35.139767) |
| 207R00000X Internal Medicine (Licence: MA 251971) | |
| 207R00000X Internal Medicine (Licence: OH 35.139767) | |
| Enumeration Date | 2012-06-04 |
| Last Update Date | 2024-10-09 |