| NPI | 1003163486 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: CO 0060170) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX BP10044535) |
| Enumeration Date | 2012-08-05 |
| Last Update Date | 2020-03-06 |