| NPI | 1609089390 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: TX R1954) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: VA 0101241245) |
| 207R00000X Internal Medicine (Licence: VA 0101241245) | |
| Enumeration Date | 2007-05-08 |
| Last Update Date | 2020-01-17 |