| NPI | 1508068487 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: OR MD185874) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: TX N1396) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: AL 29534) | |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: FL ME121074) | |
| 207R00000X Internal Medicine (Licence: FL ME104528) | |
| Enumeration Date | 2007-06-04 |
| Last Update Date | 2018-07-17 |