| NPI | 1679927230 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: MO 2025021152) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: OH 35145213) |
| Enumeration Date | 2016-04-20 |
| Last Update Date | 2025-07-25 |