| NPI | 1952433435 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: TN 21428) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: OH 53996) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: VA 0101045112) | |
| Enumeration Date | 2007-03-11 |
| Last Update Date | 2007-07-08 |