| NPI | 1265598759 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: NY 7048348) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: OH 84164) |
| Enumeration Date | 2006-12-29 |
| Last Update Date | 2012-08-13 |