NPI | 1164084653 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: SC 93701) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: SC 93701) |
207R00000X Internal Medicine (Licence: MA 280891) | |
Enumeration Date | 2019-07-03 |
Last Update Date | 2025-08-15 |