| NPI | 1124220660 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: TX P0713) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: MD D69944) |
| Enumeration Date | 2007-06-05 |
| Last Update Date | 2015-07-10 |