| NPI | 1780903518 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OH 34.009801) |
| Additional Taxonomies | 207RG0100X Internal Medicine Gastroenterology (Licence: OH 34.009801) |
| Enumeration Date | 2010-05-18 |
| Last Update Date | 2013-06-18 |