NPI | 1629276159 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: GA 073151) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301085488) |
Enumeration Date | 2007-07-05 |
Last Update Date | 2015-12-30 |