| NPI | 1639177710 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: GA 066721) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35-089406) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: OH 35-089406) | |
| Enumeration Date | 2005-07-12 |
| Last Update Date | 2018-10-19 |