| NPI | 1083658934 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: MA 224164) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: OH 356.139990) |
| Enumeration Date | 2006-06-15 |
| Last Update Date | 2021-12-27 |