| NPI | 1083065965 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: TX U4343) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MO 2016018511) |
| 207R00000X Internal Medicine (Licence: TX U4343) | |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: NC 2020-00910) | |
| Enumeration Date | 2016-06-22 |
| Last Update Date | 2023-09-12 |