NPI | 1649407289 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: MD D0082067) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0101248589) |
207RG0100X Internal Medicine, Gastroenterology (Licence: VA 0101248589) | |
208D00000X General Practice (Licence: VA 0101248589) | |
Enumeration Date | 2009-06-22 |
Last Update Date | 2020-07-13 |