| NPI | 1053722470 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: TX T3163) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: MA 273657) |
| Enumeration Date | 2014-05-20 |
| Last Update Date | 2021-10-03 |