| NPI | 1952481632 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: SC 36692) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 34.010157) |
| 207R00000X Internal Medicine (Licence: MS 20442) | |
| Enumeration Date | 2006-10-16 |
| Last Update Date | 2021-05-27 |