NPI | 1326489360 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: TX BP10055877) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: PA MT204396) |
Enumeration Date | 2013-07-06 |
Last Update Date | 2019-06-20 |