NPI | 1609851591 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: CA G85405) |
Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: VA 101231578) |
Enumeration Date | 2005-12-13 |
Last Update Date | 2007-08-28 |