| NPI | 1174010177 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: TX U9904) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX U9904) |
| Enumeration Date | 2018-04-16 |
| Last Update Date | 2025-07-07 |