NPI | 1255317285 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: FL ME163485) |
Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: MN 41632) |
Enumeration Date | 2005-12-21 |
Last Update Date | 2023-08-15 |