| NPI | 1518965813 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: AR E7733) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: TX K5792) |
| Enumeration Date | 2005-07-11 |
| Last Update Date | 2020-09-02 |