| NPI | 1568656189 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: TX M9223) |
| Additional Taxonomies | 208600000X Surgery (Licence: NM MD2007-0561) |
| 208600000X Surgery (Licence: TX M9223) | |
| Enumeration Date | 2007-08-28 |
| Last Update Date | 2025-08-21 |