NPI | 1265417893 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: TX K1748) |
Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: MT MED-PHYS-LIC-111922) |
Enumeration Date | 2005-12-06 |
Last Update Date | 2023-03-15 |