NPI | 1891784773 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: AZ 23695) |
Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: TX H0572) |
207RG0100X Internal Medicine, Gastroenterology (Licence: LA MD.07239R) | |
207RG0100X Internal Medicine, Gastroenterology (Licence: FL ME59255) | |
207RG0100X Internal Medicine, Gastroenterology (Licence: MN 32275) | |
Enumeration Date | 2005-10-13 |
Last Update Date | 2020-09-01 |