| NPI | 1073176715 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: TX BP20081702) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX BP10067721) |
| Enumeration Date | 2019-04-18 |
| Last Update Date | 2022-06-30 |