| NPI | 1184854747 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: OH 35132678) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NM RS2009-0393) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: NM MD2015-0159) | |
| Enumeration Date | 2009-07-17 |
| Last Update Date | 2017-12-13 |