| NPI | 1760881304 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: OH 35.139520) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: MD D86567) |
| Enumeration Date | 2014-08-20 |
| Last Update Date | 2026-08-13 |