| NPI | 1033313614 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: VA 0101251231)  | 
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: OH 35131874)  | 
| Enumeration Date | 2007-06-14 | 
| Last Update Date | 2021-05-19 |