| NPI | 1528090446 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: TX G0901) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: CO DR.0065999) |
| Enumeration Date | 2006-07-07 |
| Last Update Date | 2023-08-18 |