| NPI | 1215119516 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: CO 048988) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX P5129) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: TX P5129) | |
| Enumeration Date | 2007-11-29 |
| Last Update Date | 2021-05-07 |