| NPI | 1710482922 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: OH 35.150026) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125.072049) |
| Enumeration Date | 2018-03-28 |
| Last Update Date | 2024-07-09 |