| NPI | 1265413876 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: OH 35C.001398) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: LA L021618) |
| Enumeration Date | 2005-11-10 |
| Last Update Date | 2024-03-15 |