| NPI | 1275826901 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: NE 30525) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35.123722) |
| 207RG0100X Internal Medicine Gastroenterology (Licence: OH 35123722) | |
| Enumeration Date | 2011-05-27 |
| Last Update Date | 2019-03-12 |