| NPI | 1114304029 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: OH 012713) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: PA OS019196) |
| Enumeration Date | 2015-04-29 |
| Last Update Date | 2026-04-01 |