NPI | 1780181610 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: FL ME166987) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: IL 036.156356) |
Enumeration Date | 2018-04-08 |
Last Update Date | 2024-05-14 |