| NPI | 1588735617 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: TN 41980) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: TX L6406) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: MS 19685) | |
| Enumeration Date | 2006-11-12 |
| Last Update Date | 2007-07-08 |