| NPI | 1508357120 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: OH 35.152530) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: AR T2018-098) |
| Enumeration Date | 2018-05-21 |
| Last Update Date | 2025-03-06 |