| NPI | 1255750741 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: CA A140681) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX BP10049478) |
| 207R00000X Internal Medicine (Licence: CA A140681) | |
| Enumeration Date | 2014-04-10 |
| Last Update Date | 2023-08-04 |