| NPI | 1942566112 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: IA MD-44099) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IA MD-44099) |
| 207R00000X Internal Medicine (Licence: OH 35.126070) | |
| Enumeration Date | 2012-04-02 |
| Last Update Date | 2022-05-19 |