| NPI | 1912299553 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: OH 35.136037) |
| Additional Taxonomies | 207RG0100X Internal Medicine Gastroenterology (Licence: MA 258685) |
| Enumeration Date | 2011-05-13 |
| Last Update Date | 2023-09-20 |