| NPI | 1114107026 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: UT 6354370-1205) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: UT 6354370-1205) |
| Enumeration Date | 2007-11-07 |
| Last Update Date | 2015-06-09 |