| NPI | 1316144405 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: TX M7751) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: WA MD60103172 (pending)) |
| Enumeration Date | 2007-07-02 |
| Last Update Date | 2011-02-22 |