| NPI | 1871603563 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208C00000X Colon & Rectal Surgery (Licence: OH 34.005168) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: OH 34005168G) |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2021-11-03 |