| NPI | 1558620351 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: TX Q1498) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX BP10043118) |
| 207R00000X Internal Medicine (Licence: TX Q1498) | |
| Enumeration Date | 2012-05-14 |
| Last Update Date | 2024-04-29 |