| NPI | 1720161854 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: OH 35097183) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MO 2006024361) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: ME EC101065) | |
| Enumeration Date | 2006-10-23 |
| Last Update Date | 2023-11-07 |