| NPI | 1487061768 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: OH 35.137580) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35.137580) |
| 207R00000X Internal Medicine (Licence: AR E-11585) | |
| Enumeration Date | 2014-07-17 |
| Last Update Date | 2026-06-08 |