| NPI | 1699725366 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: TX P4764) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: SC 40471) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: MD D23650) | |
| Enumeration Date | 2006-05-11 |
| Last Update Date | 2019-05-20 |