| NPI | 1003236936 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: CO DR.0063317) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: UT 14281517-1204) |
| 207R00000X Internal Medicine (Licence: TX BP10048760) | |
| Enumeration Date | 2014-04-17 |
| Last Update Date | 2026-05-29 |