| NPI | 1629061171 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: TX P8720) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: TN 35969) |
| Enumeration Date | 2005-08-30 |
| Last Update Date | 2024-03-19 |