| NPI | 1396128682 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: TX T3981) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: FL ME172668) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: MO 2022018674) | |
| Enumeration Date | 2015-07-03 |
| Last Update Date | 2026-06-05 |