NPI | 1033320403 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: VA 0101266157) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: CT 044924) |
207RG0100X Internal Medicine, Gastroenterology (Licence: PA MD453081) | |
207RG0100X Internal Medicine, Gastroenterology (Licence: SC TL 30651) | |
Enumeration Date | 2007-05-25 |
Last Update Date | 2023-12-19 |