| NPI | 1255493185 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: OH 35086125) |
| Additional Taxonomies | 282N00000X General Acute Care Hospital (Licence: KY 40549) |
| Enumeration Date | 2006-12-15 |
| Last Update Date | 2024-04-18 |