| NPI | 1306929435 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: OH 35.125020) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MO 2007022716) |
| 207R00000X Internal Medicine (Licence: PA MD428129) | |
| 207RG0100X Internal Medicine Gastroenterology (Licence: MO 2007022716) | |
| 208M00000X Hospitalist (Licence: LA MD.203986) | |
| Enumeration Date | 2006-10-23 |
| Last Update Date | 2018-11-06 |