| NPI | 1194927533 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: OH 35030461) |
| Additional Taxonomies | 2086X0206X Surgery Surgical Oncology (Licence: OH 35030461) |
| 208C00000X Colon & Rectal Surgery (Licence: OH 35030461) | |
| Enumeration Date | 2007-06-05 |
| Last Update Date | 2007-07-08 |