| NPI | 1912966391 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: KY 53133) |
| Additional Taxonomies | 207RG0100X Internal Medicine Gastroenterology (Licence: TX G0573) |
| Enumeration Date | 2006-03-22 |
| Last Update Date | 2020-06-10 |