NPI | 1962812982 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: SD 12467) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: MO 2014014710) |
Enumeration Date | 2014-04-29 |
Last Update Date | 2022-04-18 |