| NPI | 1265420699 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: TX J0784) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: MS 16751) |
| Enumeration Date | 2005-10-10 |
| Last Update Date | 2016-01-25 |