| NPI | 1245674282 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: TX V8013) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NE 1276) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: NE 1276) | |
| 208D00000X General Practice (Licence: NE 1276) | |
| Enumeration Date | 2013-04-22 |
| Last Update Date | 2026-01-12 |