| NPI | 1790771715 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: KS 04-46337) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: TX J1796) |
| Enumeration Date | 2005-09-26 |
| Last Update Date | 2025-05-15 |