NPI | 1437290053 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: OH 35-096540) |
Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program (Licence: OH 35.096540) |
Enumeration Date | 2007-02-08 |
Last Update Date | 2012-12-05 |