NPI | 1295738797 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: ID 0-122) |
Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: MT MEDPHYSCOMLIC114155) |
Enumeration Date | 2005-05-27 |
Last Update Date | 2024-01-02 |