| NPI | 1578564506 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: CA G193185) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: TX H2370) |
| Enumeration Date | 2005-08-01 |
| Last Update Date | 2025-02-28 |