| NPI | 1295830511 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: TX N2748) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: LA 4004R) |
| Enumeration Date | 2006-09-13 |
| Last Update Date | 2009-11-23 |