NPI | 1104922251 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: MO R3N38) |
Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: IN 02002257A) |
207RG0100X Internal Medicine, Gastroenterology (Licence: KS 05-31088) | |
Enumeration Date | 2006-09-16 |
Last Update Date | 2007-07-08 |