| NPI | 1164533477 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: TX P2940) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MO 2005020207) |
| 207R00000X Internal Medicine (Licence: MO 2008025334) | |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2015-07-30 |