NPI | 1659716579 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: PR 19361) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: PR 19361) |
Enumeration Date | 2013-05-06 |
Last Update Date | 2021-03-01 |