| NPI | 1962616409 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: KY 52221) |
| Additional Taxonomies | 207RG0100X Internal Medicine Gastroenterology (Licence: OH 35.091296) |
| 207RG0100X Internal Medicine Gastroenterology (Licence: IN 01081627A) | |
| Enumeration Date | 2007-05-10 |
| Last Update Date | 2020-09-10 |