NPI | 1992785430 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: FL 107559) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35-091529) |
207RG0100X Internal Medicine, Gastroenterology (Licence: VA 0101055128) | |
207RG0100X Internal Medicine, Gastroenterology (Licence: OH 35.091529) | |
Enumeration Date | 2006-01-19 |
Last Update Date | 2024-04-18 |