| NPI | 1912090317 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: TX K6821) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: IL 036145783) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: OH 35.141601) | |
| Enumeration Date | 2006-09-30 |
| Last Update Date | 2022-01-13 |