| NPI | 1376550285 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: OH 35068148) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: KY 38133) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: KY 38133) | |
| Enumeration Date | 2006-08-02 |
| Last Update Date | 2011-08-17 |