NPI | 1104094739 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: MD D69337) |
Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: PA MT185907) |
Enumeration Date | 2008-02-17 |
Last Update Date | 2013-02-11 |