NPI | 1184043861 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: TX s5141) |
Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: OH 35.146468) |
390200000X Student in an Organized Health Care Education/Training Program | |
Enumeration Date | 2014-04-10 |
Last Update Date | 2022-09-26 |