| NPI | 1104087865 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: OH 35.126378) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: OH 126378) |
| Enumeration Date | 2008-06-24 |
| Last Update Date | 2022-06-06 |