| NPI | 1952759078 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: MN 79485) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35.137018) |
| Enumeration Date | 2016-05-31 |
| Last Update Date | 2025-06-13 |