| NPI | 1558630715 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: NY 322121) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35124454) |
| Enumeration Date | 2011-12-17 |
| Last Update Date | 2023-07-14 |