| NPI | 1154709814 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: TX U8416) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: FL 154105) |
| Enumeration Date | 2015-05-14 |
| Last Update Date | 2024-11-21 |