| NPI | 1740506195 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: WI 65262) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 121652) |
| Enumeration Date | 2010-04-09 |
| Last Update Date | 2020-10-25 |