| NPI | 1225227507 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: FL ME118891) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 57012862) |
| Enumeration Date | 2007-10-23 |
| Last Update Date | 2021-08-24 |