| NPI | 1053755652 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: MS 25780) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX BP10047200) |
| 207R00000X Internal Medicine (Licence: LA 302392) | |
| Enumeration Date | 2013-04-25 |
| Last Update Date | 2020-07-14 |