| NPI | 1952300899 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: OH 35.048678) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: WI 32055) |
| Enumeration Date | 2005-07-21 |
| Last Update Date | 2021-05-17 |