NPI | 1679663389 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: CT 51164) |
Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: NJ MA074833) |
207RG0100X Internal Medicine, Gastroenterology (Licence: DE C10007588) | |
Enumeration Date | 2006-10-13 |
Last Update Date | 2012-08-10 |