NPI | 1568604502 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: TX T0458) |
Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: NY 291153) |
207RG0100X Internal Medicine, Gastroenterology (Licence: TN 52518) | |
207RG0100X Internal Medicine, Gastroenterology (Licence: MO 2019010501) | |
Enumeration Date | 2009-04-06 |
Last Update Date | 2023-01-04 |