NPI | 1225398704 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: NY 296750) |
Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: PA MD463601) |
207RG0100X Internal Medicine, Gastroenterology (Licence: VA 0101269644) | |
Enumeration Date | 2012-05-18 |
Last Update Date | 2022-08-26 |