| NPI | 1306905187 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: TX Q5339) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: WI 49563-020) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: MO 2010028601) | |
| Enumeration Date | 2006-12-07 |
| Last Update Date | 2022-05-17 |