| NPI | 1508030925 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: MN 54485) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: MI 5101021501) |
| 207R00000X Internal Medicine (Licence: MI 5101021501) | |
| 207R00000X Internal Medicine (Licence: OH 58.002509) | |
| Enumeration Date | 2008-04-16 |
| Last Update Date | 2020-09-30 |