| NPI | 1609070275 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: TX N5214) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX BP2-0029546) |
| Enumeration Date | 2007-06-14 |
| Last Update Date | 2011-05-17 |