| NPI | 1245658202 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: TX T6700) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 4301105717) |
| Enumeration Date | 2014-04-06 |
| Last Update Date | 2022-06-14 |