| NPI | 1700157450 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: OH 35.129593) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: IA MD51453) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: PA MD461438) | |
| Enumeration Date | 2012-01-25 |
| Last Update Date | 2026-07-02 |