| NPI | 1013133412 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: MI 4301095946) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35.093025) |
| Enumeration Date | 2007-04-17 |
| Last Update Date | 2023-10-19 |