| NPI | 1972684645 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: CA A111725) |
| Additional Taxonomies | 174400000X Specialist (Licence: OH 35-088558) |
| Enumeration Date | 2006-10-18 |
| Last Update Date | 2020-05-28 |