| NPI | 1700204443 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: CA A167883) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 57.024637) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: IL 036.143497) | |
| Enumeration Date | 2014-03-31 |
| Last Update Date | 2020-08-27 |