| NPI | 1780691923 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: TX 154192) |
| Additional Taxonomies | 174400000X Specialist (Licence: TX M1931) |
| Enumeration Date | 2006-08-01 |
| Last Update Date | 2014-09-24 |