NPI | 1205813763 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: OH 35.088347) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: KY 37905) |
Enumeration Date | 2005-12-27 |
Last Update Date | 2020-11-19 |