| NPI | 1578068284 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: PA OS021849) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX S3282) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: CO DR.0072792) | |
| Enumeration Date | 2018-03-26 |
| Last Update Date | 2024-04-24 |