| NPI | 1265417893 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: TX K1748) |
| Additional Taxonomies | 207RG0100X Internal Medicine Gastroenterology (Licence: MT MED-PHYS-LIC-111922) |
| Enumeration Date | 2005-12-06 |
| Last Update Date | 2023-03-15 |