NPI | 1659421113 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: VA 0101050196) |
Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: MD D0045252) |
207RG0100X Internal Medicine, Gastroenterology (Licence: DC MD9857) | |
Enumeration Date | 2007-01-10 |
Last Update Date | 2011-11-09 |