| NPI | 1982816310 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: TX P1475) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AL L2766R) |
| Enumeration Date | 2007-05-06 |
| Last Update Date | 2017-10-02 |