| NPI | 1851685812 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: OH 35138274) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NE 6529) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: MN 57706) | |
| Enumeration Date | 2011-06-07 |
| Last Update Date | 2020-12-17 |