NPI | 1053575399 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: IL 036.138013) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 57.014359) |
207RG0100X Internal Medicine, Gastroenterology (Licence: FL ME118395) | |
Enumeration Date | 2008-07-16 |
Last Update Date | 2022-10-25 |