| NPI | 1205814316 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: TX N9333) |
| Additional Taxonomies | 207RG0100X Internal Medicine Gastroenterology (Licence: ND 11133) |
| Enumeration Date | 2006-01-09 |
| Last Update Date | 2018-03-17 |