| NPI | 1649269226 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: KY 45134) |
| Additional Taxonomies | 207RG0100X Internal Medicine Gastroenterology (Licence: OH 35079042) |
| Enumeration Date | 2005-10-17 |
| Last Update Date | 2018-08-31 |