| NPI | 1801286711 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: NE 34764) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35823495) |
| 207RG0100X Internal Medicine Gastroenterology (Licence: KY 53641) | |
| Enumeration Date | 2015-01-30 |
| Last Update Date | 2022-09-12 |