| NPI | 1295939361 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: OH 35124022) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 50847) |
| Enumeration Date | 2007-06-13 |
| Last Update Date | 2021-02-25 |