NPI | 1396128682 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: FL ME172668) |
Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: MO 2022018674) |
207RG0100X Internal Medicine, Gastroenterology (Licence: TX T3981) | |
Enumeration Date | 2015-07-03 |
Last Update Date | 2025-06-24 |