| NPI | 1659932796 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: MN 71123) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 57.247830) |
| Enumeration Date | 2019-06-27 |
| Last Update Date | 2022-12-07 |