| NPI | 1811007883 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: TX L9026) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: IL 036.118102) |
| Enumeration Date | 2006-08-30 |
| Last Update Date | 2020-09-25 |