NPI | 1710905823 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: PA MD070996L) |
Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: ME MD 19494) |
Enumeration Date | 2006-07-17 |
Last Update Date | 2014-04-04 |