| NPI | 1508845553 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: OH 35.136585) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: MN 48007) |
| Enumeration Date | 2006-01-10 |
| Last Update Date | 2020-12-17 |