| NPI | 1922003680 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: TX L5127) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX L5127) |
| Enumeration Date | 2005-06-17 |
| Last Update Date | 2023-06-28 |