| NPI | 1144857053 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: TX U9910) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX U9910) |
| 207R00000X Internal Medicine (Licence: PA MT221594) | |
| Enumeration Date | 2020-03-23 |
| Last Update Date | 2026-03-23 |