NPI | 1912299553 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: OH 35.136037) |
Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: MA 258685) |
Enumeration Date | 2011-05-13 |
Last Update Date | 2023-09-20 |