| NPI | 1538456660 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: TX U3225) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301103117) |
| 207R00000X Internal Medicine (Licence: OH 57.017380) | |
| Enumeration Date | 2011-07-10 |
| Last Update Date | 2023-10-04 |