| NPI | 1972981843 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: TX R7507) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX 593771) |
| Enumeration Date | 2015-05-12 |
| Last Update Date | 2022-06-21 |