| NPI | 1356379150 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: TX E8706) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: OK 16082) |
| Enumeration Date | 2006-06-29 |
| Last Update Date | 2018-09-14 |