NPI | 1841284049 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: NE 19838) |
Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: MT MED-PHYS-LIC-112103) |
Enumeration Date | 2005-09-02 |
Last Update Date | 2024-06-20 |