| NPI | 1972745024 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: UT 9388734-1205) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: NC 2012-00510) |
| 207R00000X Internal Medicine (Licence: NC 2012-00510) | |
| Enumeration Date | 2009-04-02 |
| Last Update Date | 2016-05-10 |