| NPI | 1912224957 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: UT 11191800-1205) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: MD D85025) |
| Enumeration Date | 2010-04-30 |
| Last Update Date | 2025-12-10 |