NPI | 1407810476 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: FL ME132562) |
Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: NC 9400086) |
207R00000X Internal Medicine (Licence: NC 9400086) | |
Enumeration Date | 2006-04-14 |
Last Update Date | 2019-05-24 |