| NPI | 1811073166 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: TX N6556) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: MO 2009008670) |
| Enumeration Date | 2006-10-30 |
| Last Update Date | 2012-07-30 |