| NPI | 1033116157 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: OH 35.072572) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: WV 19757) |
| Enumeration Date | 2005-07-05 |
| Last Update Date | 2020-05-12 |