| NPI | 1477578136 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: OH 35.064997) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: WV 13211) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: PA MD028222E) | |
| Enumeration Date | 2006-07-13 |
| Last Update Date | 2021-03-03 |