| NPI | 1316384704 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: TX U4498) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: KS 9408138) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: KS 9408138) | |
| Enumeration Date | 2013-05-27 |
| Last Update Date | 2023-07-13 |