| NPI | 1639339039 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: OH 35.139140) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: NY 246039) |
| Enumeration Date | 2008-06-10 |
| Last Update Date | 2020-04-08 |