| NPI | 1922129774 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: TX T3113) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: WI 52028-20) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: CO 45722) | |
| Enumeration Date | 2007-04-02 |
| Last Update Date | 2022-04-05 |