| NPI | 1265636823 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: TX M2319) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX M2319) |
| Enumeration Date | 2007-06-14 |
| Last Update Date | 2013-10-10 |