| NPI | 1891784773 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: AZ 23695) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: TX H0572) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: MN 32275) | |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: FL ME59255) | |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: LA MD.07239R) | |
| Enumeration Date | 2005-10-13 |
| Last Update Date | 2025-10-10 |