NPI | 1669443909 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: ID M-12760) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: VA 0101239001) |
207RG0100X Internal Medicine, Gastroenterology (Licence: ND 12112) | |
Enumeration Date | 2006-01-26 |
Last Update Date | 2015-07-09 |