| NPI | 1508308552 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: OH 35.150496) |
| Additional Taxonomies | 207RG0100X Internal Medicine Gastroenterology (Licence: MA 290612) |
| Enumeration Date | 2016-11-08 |
| Last Update Date | 2024-05-09 |