NPI | 1003895590 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: MN 35742) |
Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: AZ 24999) |
207RG0100X Internal Medicine, Gastroenterology (Licence: IA MD-31755) | |
207RG0100X Internal Medicine, Gastroenterology (Licence: WI 36565) | |
Enumeration Date | 2006-01-12 |
Last Update Date | 2020-08-18 |