NPI | 1255827903 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: FL ME148541) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125071661) |
Enumeration Date | 2018-07-05 |
Last Update Date | 2021-07-01 |