| NPI | 1366563959 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: TX L6176) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: GA 055794) |
| Enumeration Date | 2007-04-02 |
| Last Update Date | 2010-11-18 |