NPI | 1215908819 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: MD d0067403) |
Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: DC md037959) |
207RG0100X Internal Medicine, Gastroenterology (Licence: VA 0101245606) | |
Enumeration Date | 2006-01-31 |
Last Update Date | 2011-02-23 |