| NPI | 1114034345 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: MO 2009007877) |
| Additional Taxonomies | 207RG0100X Internal Medicine Gastroenterology (Licence: TX M0538) |
| Enumeration Date | 2006-08-24 |
| Last Update Date | 2021-01-21 |