NPI | 1265703300 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: CA A122533) |
Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: CA a122533) |
207RG0100X Internal Medicine, Gastroenterology (Licence: SC 84078) | |
Enumeration Date | 2012-01-20 |
Last Update Date | 2021-03-23 |