NPI | 1164800173 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: CO DR.0066149) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301117185) |
Enumeration Date | 2015-05-11 |
Last Update Date | 2021-07-06 |