| NPI | 1619237534 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: AZ 55630) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX BP10044655) |
| Enumeration Date | 2012-05-24 |
| Last Update Date | 2019-03-13 |