| NPI | 1952759672 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: OH 35.152603) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: NY 329481) |
| Enumeration Date | 2016-06-03 |
| Last Update Date | 2025-06-06 |