| NPI | 1477949675 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: TX BP10052896) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX BP10052896) |
| Enumeration Date | 2015-04-14 |
| Last Update Date | 2021-07-29 |