| NPI | 1770929226 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: WI 63903) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: TX S5890) |
| Enumeration Date | 2013-05-10 |
| Last Update Date | 2020-07-20 |