| NPI | 1578793634 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: TX P0803) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX P0803) |
| Enumeration Date | 2009-07-22 |
| Last Update Date | 2015-03-24 |