| NPI | 1063538676 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: MO 2007006292) |
| Additional Taxonomies | 207RG0100X Internal Medicine Gastroenterology (Licence: TX P8793) |
| Enumeration Date | 2007-03-22 |
| Last Update Date | 2014-08-06 |