| NPI | 1497072243 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: MI 4301111716) | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX P7120) | 
| 207R00000X Internal Medicine (Licence: TX BP1-0036662) | |
| Enumeration Date | 2010-05-03 | 
| Last Update Date | 2019-02-05 |