| NPI | 1487997623 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208M00000X Hospitalist (Licence: PA OS020542) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 34.012222) |
| 207RG0100X Internal Medicine Gastroenterology (Licence: PA OS020542) | |
| Enumeration Date | 2013-04-05 |
| Last Update Date | 2020-07-13 |