| NPI | 1770696718 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: TX D5927) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX D5927) |
| Enumeration Date | 2006-08-16 |
| Last Update Date | 2008-06-29 |