| NPI | 1093716375 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: CO DR.0065485) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: TX J1289) |
| Enumeration Date | 2005-08-09 |
| Last Update Date | 2021-01-20 |