| NPI | 1821309592 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: NC 2017-02526) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX N1755) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: TX N1755) | |
| Enumeration Date | 2010-06-28 |
| Last Update Date | 2018-03-17 |