NPI | 1407839533 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: SC 12380) |
Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: GA 29976) |
207RG0100X Internal Medicine, Gastroenterology (Licence: CO DR.0044124) | |
Enumeration Date | 2005-11-22 |
Last Update Date | 2022-01-19 |