| NPI | 1376714519 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: TX 999999) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: GA 002860) |
| 207R00000X Internal Medicine (Licence: GA 065143) | |
| Enumeration Date | 2008-03-16 |
| Last Update Date | 2014-07-04 |