NPI | 1083696298 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: CT 081462) |
Additional Taxonomies | 207RX0202X Internal Medicine, Medical Oncology (Licence: CT 081462) |
207RG0100X Internal Medicine, Gastroenterology (Licence: MA 203754) | |
207RX0202X Internal Medicine, Medical Oncology (Licence: MA 203754) | |
Enumeration Date | 2005-11-15 |
Last Update Date | 2025-08-20 |