| NPI | 1396128682 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: MO 2022018674) |
| Additional Taxonomies | 207RG0100X Internal Medicine Gastroenterology (Licence: TX T3981) |
| Enumeration Date | 2015-07-03 |
| Last Update Date | 2022-07-15 |