| NPI | 1689844888 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: MO 2008007444) |
| Additional Taxonomies | 174400000X Specialist (Licence: MO 2008007444) |
| 207R00000X Internal Medicine (Licence: OH 57005530) | |
| Enumeration Date | 2008-03-04 |
| Last Update Date | 2021-04-07 |