| NPI | 1154749216 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: OH 35.134372) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: MA 290483) |
| Enumeration Date | 2014-04-04 |
| Last Update Date | 2023-10-02 |