| NPI | 1003025032 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: IA 36747) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: IA 36747) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: TX P8660) | |
| Enumeration Date | 2007-05-22 |
| Last Update Date | 2021-09-02 |