NPI | 1003163486 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: CO 0060170) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX BP10044535) |
Enumeration Date | 2012-08-05 |
Last Update Date | 2020-03-06 |