| NPI | 1558477489 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: OH 35128599) |
| Additional Taxonomies | 207RG0100X Internal Medicine Gastroenterology (Licence: VA 0101245745) |
| 207RG0100X Internal Medicine Gastroenterology (Licence: KY 44628) | |
| Enumeration Date | 2006-08-22 |
| Last Update Date | 2023-06-30 |