| NPI | 1396705455 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: OH 35.096655) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 55544) |
| 207R00000X Internal Medicine (Licence: OH 35.096655) | |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: MA 55544) | |
| Enumeration Date | 2006-03-24 |
| Last Update Date | 2017-07-10 |