NPI | 1073565917 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: MI 4301069020) |
Additional Taxonomies | 207RG0100X Internal Medicine Gastroenterology (Licence: OH 35.138267) |
Enumeration Date | 2006-05-17 |
Last Update Date | 2021-01-18 |