NPI | 1205814316 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: TX N9333) |
Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: ND 11133) |
Enumeration Date | 2006-01-09 |
Last Update Date | 2018-03-17 |