| NPI | 1295768174 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: OH 35.122123) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: PR 10463) |
| Enumeration Date | 2006-07-07 |
| Last Update Date | 2014-01-29 |