| NPI | 1205813763 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: OH 35.088347) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: KY 37905) |
| Enumeration Date | 2005-12-27 |
| Last Update Date | 2020-11-19 |