| NPI | 1669725057 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: OH 35128565) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NJ 25MA09712700) |
| 207R00000X Internal Medicine (Licence: IL 036.139080) | |
| Enumeration Date | 2012-10-22 |
| Last Update Date | 2016-08-30 |