| NPI | 1194828517 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: NY 192819) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: OH 35.143541) |
| Enumeration Date | 2006-09-07 |
| Last Update Date | 2021-11-03 |