NPI | 1033105903 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: FL ME142694) |
Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: NJ 25MA065097) |
207RG0100X Internal Medicine, Gastroenterology (Licence: KY 51971) | |
Enumeration Date | 2005-09-26 |
Last Update Date | 2021-03-30 |