| NPI | 1891943098 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: TX Q0366) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: NY 270067) |
| Enumeration Date | 2008-09-03 |
| Last Update Date | 2025-12-26 |