| NPI | 1245220763 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: MD D93995) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: OH 35053410) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: VA 0101058637) | |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: FL ME106048) | |
| Enumeration Date | 2005-10-26 |
| Last Update Date | 2022-12-05 |