| NPI | 1356830533 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: UT 14118251) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: NY 326897) |
| Enumeration Date | 2018-05-03 |
| Last Update Date | 2025-06-27 |