| NPI | 1912346057 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: TX S1901) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: TX S19101) |
| Enumeration Date | 2013-06-21 |
| Last Update Date | 2021-09-01 |