| NPI | 1073613808 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: MI 4301078184) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301078184) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: OH 35131908) | |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: MA 267487) | |
| Enumeration Date | 2006-09-22 |
| Last Update Date | 2023-10-05 |