| NPI | 1124524632 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: KY 60949) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CA a164701) |
| 208M00000X Hospitalist (Licence: OH 35.144424) | |
| Enumeration Date | 2018-04-03 |
| Last Update Date | 2025-07-23 |