NPI | 1902083587 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: WA MD60270097) |
Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: MN 104295) |
207R00000X Internal Medicine (Licence: GA 002021) | |
207RG0100X Internal Medicine, Gastroenterology (Licence: MN 52138) | |
Enumeration Date | 2008-01-26 |
Last Update Date | 2021-03-31 |