NPI | 1811124886 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: MO 2011004665) |
Additional Taxonomies | 174400000X Specialist (Licence: NY 2536871) |
207RG0100X Internal Medicine, Gastroenterology (Licence: IN 01066972A) | |
Enumeration Date | 2009-06-17 |
Last Update Date | 2011-02-23 |