NPI | 1649231440 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 208600000X Surgery (Licence: FL ME108804) |
Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: OH 35.089113) |
207RG0100X Internal Medicine, Gastroenterology (Licence: FL ME108804) | |
Enumeration Date | 2006-03-31 |
Last Update Date | 2025-08-11 |