| NPI | 1811087463 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: OH 091685) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0101037925) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: VA 0101037925) | |
| Enumeration Date | 2006-10-13 |
| Last Update Date | 2012-01-04 |