| NPI | 1568435394 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: TX N3833) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: MD D67712) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: TX TEMP) | |
| Enumeration Date | 2006-02-10 |
| Last Update Date | 2014-10-13 |