| NPI | 1164649588 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: OH 35-089511) |
| Additional Taxonomies | 207RG0100X Internal Medicine Gastroenterology (Licence: OH 35-089511) |
| Enumeration Date | 2007-04-19 |
| Last Update Date | 2018-10-15 |