NPI | 1760640130 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: FL ME117173) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: KY 41603) |
207RG0100X Internal Medicine, Gastroenterology (Licence: KY 41603) | |
Enumeration Date | 2008-06-01 |
Last Update Date | 2020-03-19 |