| NPI | 1720039019 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: IL 036-109579) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: WI 42-321) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: OH 34.009319) | |
| Enumeration Date | 2006-05-12 |
| Last Update Date | 2025-01-24 |