| NPI | 1588616205 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: TX H2225) | 
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: MI 5101010847) | 
| Enumeration Date | 2006-05-17 | 
| Last Update Date | 2024-11-05 |