NPI | 1922397017 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: SC 52820) |
Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: TX Q0307) |
Enumeration Date | 2011-03-30 |
Last Update Date | 2018-10-01 |