| NPI | 1629163613 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: TX N1316) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: AL 18655) |
| Enumeration Date | 2006-10-04 |
| Last Update Date | 2011-01-18 |