| NPI | 1245315811 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: TX H4107) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: TX H-4107) |
| Enumeration Date | 2006-10-25 |
| Last Update Date | 2024-05-29 |