| NPI | 1760438873 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: CA A75305) |
| Additional Taxonomies | 207RG0100X Internal Medicine Gastroenterology (Licence: TX M1049) |
| 207RG0100X Internal Medicine Gastroenterology (Licence: AZ 34631) | |
| Enumeration Date | 2006-05-26 |
| Last Update Date | 2021-11-29 |