| NPI | 1790726446 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: OH 35-092368) |
| Additional Taxonomies | 207RG0100X Internal Medicine Gastroenterology (Licence: VA 0101037937) |
| Enumeration Date | 2006-06-10 |
| Last Update Date | 2017-07-10 |