| NPI | 1568576155 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: TX N5238) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: LA MD023999) |
| Enumeration Date | 2006-08-19 |
| Last Update Date | 2016-08-19 |