| NPI | 1508250986 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: OH 35.145161) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: MI 4301507267) |
| Enumeration Date | 2015-03-24 |
| Last Update Date | 2025-05-27 |