| NPI | 1285667410 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: WV 22218) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WV 22218) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: OH 35.096331) | |
| 207RG0300X Internal Medicine, Geriatric Medicine (Licence: WV 22218) | |
| Enumeration Date | 2006-07-09 |
| Last Update Date | 2021-11-01 |