| NPI | 1902224819 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: OH 35.135278) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35.135278) |
| 207R00000X Internal Medicine (Licence: OH 57.025257) | |
| Enumeration Date | 2014-03-29 |
| Last Update Date | 2022-01-13 |