NPI | 1558477489 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: OH 35128599) |
Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: VA 0101245745) |
207RG0100X Internal Medicine, Gastroenterology (Licence: KY 44628) | |
Enumeration Date | 2006-08-22 |
Last Update Date | 2023-06-30 |