NPI | 1356376719 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: NJ 25MA05187500) |
Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: OH 35.143014) |
Enumeration Date | 2006-07-12 |
Last Update Date | 2021-08-24 |