| NPI | 1003182593 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: CA A162022) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: OH 123309) |
| Enumeration Date | 2012-03-28 |
| Last Update Date | 2021-11-29 |