| NPI | 1508200825 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: TX V2348) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: FL ME116019) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: PA MD459914) | |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: AR E-13351) | |
| Enumeration Date | 2013-04-18 |
| Last Update Date | 2024-10-07 |