NPI | 1154575892 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: WA MD60724633) |
Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: TN 71002) |
207RG0100X Internal Medicine, Gastroenterology (Licence: OR MD226989) | |
Enumeration Date | 2008-11-07 |
Last Update Date | 2025-10-17 |