NPI | 1003937244 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: FL ME89177) |
Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: WV 25049) |
207R00000X Internal Medicine (Licence: NY 234802) | |
207RG0100X Internal Medicine, Gastroenterology (Licence: TX S8378) | |
Enumeration Date | 2007-04-03 |
Last Update Date | 2024-09-13 |