| NPI | 1730224320 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: OH 35.143256) |
| Additional Taxonomies | 174400000X Specialist (Licence: TN MD0000012445) |
| Enumeration Date | 2007-02-21 |
| Last Update Date | 2024-02-22 |