| NPI | 1982642526 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: TX Q0950) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: CO DR44639) |
| Enumeration Date | 2006-06-04 |
| Last Update Date | 2017-04-06 |