| NPI | 1306287370 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: TX UA4800) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 255971) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: WI 65304-20) | |
| Enumeration Date | 2013-07-08 |
| Last Update Date | 2024-01-05 |