| NPI | 1295718153 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: NE 22910) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: OH 35.143962) |
| Enumeration Date | 2005-11-23 |
| Last Update Date | 2021-12-16 |