| NPI | 1306341904 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: WI 83483-20) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35.140174) |
| Enumeration Date | 2018-03-26 |
| Last Update Date | 2024-07-14 |