NPI | 1316021488 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: NM MD2017-0501) |
Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: CA C36054) |
207RG0100X Internal Medicine, Gastroenterology (Licence: MT MED-PHYS-LIC-79859) | |
Enumeration Date | 2006-10-25 |
Last Update Date | 2024-11-12 |