NPI | 1578769303 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: WA MD60783086) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 002851) |
207RG0100X Internal Medicine, Gastroenterology (Licence: NY 002851) | |
207RG0100X Internal Medicine, Gastroenterology (Licence: TX Q0286) | |
Enumeration Date | 2007-06-27 |
Last Update Date | 2020-12-04 |