| NPI | 1518965896 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: OH 35.041436) |
| Additional Taxonomies | 174400000X Specialist (Licence: OH 35041436-G) |
| Enumeration Date | 2005-07-12 |
| Last Update Date | 2023-03-07 |