| NPI | 1932469293 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: TX R3288) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX BP10043078) |
| Enumeration Date | 2012-05-21 |
| Last Update Date | 2018-06-26 |