| NPI | 1346419355 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: TX M6769) | 
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: TX M6769) | 
| Enumeration Date | 2008-02-23 | 
| Last Update Date | 2018-07-12 |