NPI | 1164829636 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: MO 2018030004) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: NC 2023-00874) |
207RG0100X Internal Medicine, Gastroenterology (Licence: NC 2023-00874) | |
Enumeration Date | 2014-11-29 |
Last Update Date | 2024-07-11 |