| NPI | 1578095717 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: OH 35.148279) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: PR 21732) |
| Enumeration Date | 2017-03-28 |
| Last Update Date | 2023-09-15 |