NPI | 1912042904 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: OH 35-092795) |
Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: VA 0109541140) |
Enumeration Date | 2007-02-20 |
Last Update Date | 2011-06-28 |