| NPI | 1689970568 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: MO 2019024460) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35.128506) |
| 208M00000X Hospitalist (Licence: OH 35.128506) | |
| Enumeration Date | 2011-02-09 |
| Last Update Date | 2019-11-21 |