| NPI | 1497743165 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: TX F1131) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: LA 04775R) |
| Enumeration Date | 2005-10-07 |
| Last Update Date | 2015-02-09 |