| NPI | 1508173568 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: OH 35.138586) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125055640) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: GA 075967) | |
| Enumeration Date | 2010-09-10 |
| Last Update Date | 2020-06-26 |