| NPI | 1497749790 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: TX G2539) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: TX E8822) |
| Enumeration Date | 2005-09-01 |
| Last Update Date | 2010-09-14 |