NPI | 1861888240 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: MN 69214) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: WI 66408-20) |
207R00000X Internal Medicine (Licence: PA MT216096) | |
Enumeration Date | 2015-04-13 |
Last Update Date | 2023-11-16 |