| NPI | 1407851843 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: OH 35-128181) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TN 29131) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: TN 29131) | |
| Enumeration Date | 2005-06-14 |
| Last Update Date | 2024-03-29 |