| NPI | 1104239896 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: OH 35.154417) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: KY C0269) |
| Enumeration Date | 2014-06-10 |
| Last Update Date | 2025-10-23 |