| NPI | 1720406325 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: OH 35129731) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 129731) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2014-04-01 |
| Last Update Date | 2024-10-30 |