| NPI | 1982182341 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: NE 33570) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 57.245393) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: IA MD-51523) | |
| Enumeration Date | 2018-07-29 |
| Last Update Date | 2024-04-10 |