| NPI | 1851467732 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: OH 35043027) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35043027) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: OH 35.043027) | |
| Enumeration Date | 2006-11-24 |
| Last Update Date | 2019-04-17 |