NPI | 1750547030 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: CA A154968) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 125.053739) |
207RG0100X Internal Medicine, Gastroenterology (Licence: NJ 25MA09672100) | |
Enumeration Date | 2008-08-05 |
Last Update Date | 2020-12-08 |