NPI | 1487912465 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: WV 27042) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: KY 48215) |
Enumeration Date | 2012-04-27 |
Last Update Date | 2023-06-29 |