| NPI | 1023541513 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: TX S8108) | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX S8108) | 
| Enumeration Date | 2017-04-11 | 
| Last Update Date | 2025-04-17 |