| NPI | 1902909815 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: TX Q2019) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: KS 04-26660) |
| Enumeration Date | 2006-09-06 |
| Last Update Date | 2023-11-08 |