| NPI | 1326381054 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: TX S8118) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: NY 282950-1) |
| Enumeration Date | 2013-04-01 |
| Last Update Date | 2020-12-16 |