| NPI | 1316182744 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: LA 302217) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX AR3354292) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: TN MD0000045443) | |
| Enumeration Date | 2008-12-15 |
| Last Update Date | 2016-11-14 |