NPI | 1487094397 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: TN 5880) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: NJ 25MB10357800) |
207RG0100X Internal Medicine, Gastroenterology (Licence: MI 5101027745) | |
207RG0100X Internal Medicine, Gastroenterology (Licence: MO 2021029587) | |
Enumeration Date | 2013-06-25 |
Last Update Date | 2024-09-06 |