| NPI | 1942282736 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: OH 34008140) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 34008140) |
| 207R00000X Internal Medicine (Licence: MI 5101016292) | |
| Enumeration Date | 2005-11-16 |
| Last Update Date | 2022-07-21 |