NPI | 1073524591 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: LA 11701R) |
Additional Taxonomies | 208000000X Pediatrics (Licence: LA 11701R) |
Enumeration Date | 2006-08-10 |
Last Update Date | 2017-01-09 |