| NPI | 1518929843 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: MI 5101011194) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: OH 34.015416) |
| Enumeration Date | 2006-04-03 |
| Last Update Date | 2021-10-22 |