| NPI | 1255727244 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: OH 35.147388) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WA MD60855945) |
| Enumeration Date | 2015-04-07 |
| Last Update Date | 2023-11-06 |