| NPI | 1912384389 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: UT 12142398-1204) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MI 5151010468) |
| Enumeration Date | 2015-05-05 |
| Last Update Date | 2021-05-04 |