NPI | 1821110040 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: SC 88367) |
Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: PA MD450348) |
Enumeration Date | 2007-04-06 |
Last Update Date | 2022-07-20 |