| NPI | 1639179500 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: CO DR.0066635) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: TX J2249) |
| Enumeration Date | 2005-07-21 |
| Last Update Date | 2025-03-19 |