| NPI | 1750370995 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: TX L7612) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: WI 67416) |
| Enumeration Date | 2005-10-20 |
| Last Update Date | 2023-03-07 |