| NPI | 1053377101 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: TX K6865) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: AR R-4415) |
| 207RG0100X Internal Medicine Gastroenterology (Licence: AR R-4415) | |
| Enumeration Date | 2006-04-25 |
| Last Update Date | 2022-07-19 |