NPI | 1104828201 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: OH 35.143765) |
Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: MI 4301055436) |
Enumeration Date | 2005-08-10 |
Last Update Date | 2024-04-25 |