| NPI | 1275730657 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: OH 34.014556) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: NY 305039) |
| Enumeration Date | 2007-06-29 |
| Last Update Date | 2021-06-15 |