| NPI | 1770719064 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: TX N2756) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX N2756) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: MI 4301109025) | |
| Enumeration Date | 2009-06-01 |
| Last Update Date | 2017-11-03 |