NPI | 1275648586 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: FL ME89913) |
Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: NM MD2021-0015) |
207RG0100X Internal Medicine, Gastroenterology (Licence: FL 16292) | |
Enumeration Date | 2006-08-20 |
Last Update Date | 2024-02-01 |