| NPI | 1538429972 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: NY 303422) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 57.024432) |
| Enumeration Date | 2012-05-19 |
| Last Update Date | 2023-03-06 |