| NPI | 1861653701 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: OH 35123599) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125053354) |
| Enumeration Date | 2008-06-23 |
| Last Update Date | 2023-11-06 |