| NPI | 1053548891 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: TX R6247) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: OH 35.000289) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: SC 89081) | |
| Enumeration Date | 2009-06-19 |
| Last Update Date | 2024-03-13 |