NPI | 1063619658 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: VA 0101263487) |
Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: IN 01069482A) |
207RG0100X Internal Medicine, Gastroenterology (Licence: PA MD440196) | |
Enumeration Date | 2007-06-28 |
Last Update Date | 2018-03-20 |