| NPI | 1881626091 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: TX H6856) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX H6856) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: WI 13620) | |
| Enumeration Date | 2006-07-07 |
| Last Update Date | 2025-07-29 |