| NPI | 1861662421 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: SC 40677) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: OH 35.086546) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: NC 2009-00577) | |
| Enumeration Date | 2008-03-10 |
| Last Update Date | 2020-06-01 |