| NPI | 1629678859 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: OH 35.149424) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: MN 30690) |
| Enumeration Date | 2020-10-27 |
| Last Update Date | 2024-01-24 |