| NPI | 1265721021 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: WI 70278) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35.126795) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: CA A148856) | |
| Enumeration Date | 2011-04-01 |
| Last Update Date | 2018-11-15 |