NPI | 1700875747 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: IN 01044094) |
Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: SC 87420) |
207RG0100X Internal Medicine, Gastroenterology (Licence: OH 35.065182) | |
Enumeration Date | 2005-10-20 |
Last Update Date | 2022-10-17 |