NPI | 1235270927 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: WA MD60349184) |
Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: MN 104821) |
207R00000X Internal Medicine (Licence: OK 24986) | |
207RG0100X Internal Medicine, Gastroenterology (Licence: MN 53201) | |
Enumeration Date | 2007-02-08 |
Last Update Date | 2013-07-16 |