| NPI | 1417964149 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: WV 14956) |
| Additional Taxonomies | 207RG0100X Internal Medicine Gastroenterology (Licence: OH 35060754) |
| Enumeration Date | 2006-08-02 |
| Last Update Date | 2008-07-29 |