NPI | 1629497599 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: MO 2021029809) |
Additional Taxonomies | 207RG0100X Internal Medicine Gastroenterology (Licence: MA 283578) |
Enumeration Date | 2014-04-08 |
Last Update Date | 2024-05-28 |