| NPI | 1326011487 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: TX S2963) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: MN 39946) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: AZ 24790) | |
| Enumeration Date | 2006-02-09 |
| Last Update Date | 2019-11-21 |