| NPI | 1811691934 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: NY 327272) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: OH 57.253985) |
| Enumeration Date | 2023-03-30 |
| Last Update Date | 2024-08-15 |