| NPI | 1467746503 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: TX S3684) |
| Additional Taxonomies | 208000000X Pediatrics (Licence: MA 249023) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: FL ME136457) | |
| Enumeration Date | 2011-06-07 |
| Last Update Date | 2026-05-11 |