| NPI | 1184623407 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: NM MD2021-0949) |
| Additional Taxonomies | 174400000X Specialist (Licence: TX H2396) |
| 207RG0100X Internal Medicine Gastroenterology (Licence: MT 126887) | |
| 207RG0100X Internal Medicine Gastroenterology (Licence: OR MD219009) | |
| 207RG0100X Internal Medicine Gastroenterology (Licence: TX H2396) | |
| Enumeration Date | 2005-07-19 |
| Last Update Date | 2025-09-02 |