| NPI | 1285810630 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: TX P3658) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: GA 002095) |
| Enumeration Date | 2008-01-16 |
| Last Update Date | 2017-05-08 |