| NPI | 1871024562 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: MI 4301502739) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: OH 35.149245) |
| 207R00000X Internal Medicine (Licence: MI 4301502739) | |
| Enumeration Date | 2017-03-23 |
| Last Update Date | 2025-04-14 |