| NPI | 1124286133 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: UT 9016684-1205) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IA 39640) |
| 207R00000X Internal Medicine (Licence: IA R-8339) | |
| Enumeration Date | 2008-05-27 |
| Last Update Date | 2023-11-27 |