| NPI | 1790741080 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: MN 33912) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: TX H4760) |
| Enumeration Date | 2006-04-25 |
| Last Update Date | 2008-06-10 |