| NPI | 1427373646 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: TX U9121)  | 
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: AZ 73960)  | 
| 207RG0100X Internal Medicine, Gastroenterology (Licence: WA MD60629300)  | |
| Enumeration Date | 2010-03-31 | 
| Last Update Date | 2025-02-05 |