| NPI | 1134128143 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: OH 35086075) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: KY 41159) |
| Enumeration Date | 2005-07-20 |
| Last Update Date | 2022-06-09 |