NPI | 1134115165 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: FL ME52969) |
Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: KY 52634) |
207RG0100X Internal Medicine, Gastroenterology (Licence: IN 01083133A) | |
Enumeration Date | 2005-09-26 |
Last Update Date | 2021-12-15 |