| NPI | 1831193275 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: KY 45286) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: OH 35-077244) |
| 208600000X Surgery (Licence: KY 45286) | |
| 208600000X Surgery (Licence: KY TP418) | |
| Enumeration Date | 2005-06-13 |
| Last Update Date | 2021-01-19 |