| NPI | 1780650895 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: OH 35120623) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0101235840) |
| Enumeration Date | 2006-02-28 |
| Last Update Date | 2013-11-25 |