| NPI | 1255317285 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: OH 35C.003496) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: FL ME163485) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: MN 41632) | |
| Enumeration Date | 2005-12-21 |
| Last Update Date | 2026-03-18 |