| NPI | 1346691482 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: OH 35.144899) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301109376) |
| Enumeration Date | 2016-06-30 |
| Last Update Date | 2022-05-31 |