| NPI | 1831275429 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: TX Q4841) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: SD 5925) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: SD 5925) | |
| Enumeration Date | 2006-10-27 |
| Last Update Date | 2015-08-18 |