| NPI | 1003102211 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: FL ME139195) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: TX R6457) |
| Enumeration Date | 2011-06-27 |
| Last Update Date | 2020-09-14 |