| NPI | 1396162228 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: TX S5667) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 012137) |
| 207R00000X Internal Medicine (Licence: FL OS14550) | |
| Enumeration Date | 2014-03-28 |
| Last Update Date | 2023-09-20 |