| NPI | 1508851882 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: TX G0712) |
| Additional Taxonomies | 2083A0100X Preventive Medicine, Aerospace Medicine (Licence: TX G0172) |
| 207R00000X Internal Medicine (Licence: TX G0712) | |
| Enumeration Date | 2005-09-13 |
| Last Update Date | 2022-04-20 |