| NPI | 1881733871 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: TX N8054) | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX N8054) | 
| 207R00000X Internal Medicine (Licence: NM 2004-0378) | |
| Enumeration Date | 2007-02-06 | 
| Last Update Date | 2025-09-19 |