| NPI | 1174718308 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: TX P0815) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX P0815) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: MN 50214) | |
| Enumeration Date | 2007-09-11 |
| Last Update Date | 2022-07-06 |