| NPI | 1811187354 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: TX R9190) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: LA MD.203838) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: LA MD.203838) | |
| Enumeration Date | 2007-07-31 |
| Last Update Date | 2019-01-08 |