| NPI | 1558892588 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: TX V1149) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX V1149) |
| 207R00000X Internal Medicine (Licence: PA MD480688) | |
| Enumeration Date | 2017-03-22 |
| Last Update Date | 2025-11-05 |