| NPI | 1285920751 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: TX R2574) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MN 55262) |
| Enumeration Date | 2011-06-23 |
| Last Update Date | 2022-11-30 |