| NPI | 1326083148 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: TX Q0899) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: MO 2008001013) |
| Enumeration Date | 2006-06-17 |
| Last Update Date | 2016-09-02 |