| NPI | 1184750325 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: WV 22684) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: KY 38707) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: OH 35.135080) | |
| Enumeration Date | 2007-02-24 |
| Last Update Date | 2022-04-28 |