| NPI | 1922133958 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: TX L4193) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: TX L4193) |
| Enumeration Date | 2007-02-22 |
| Last Update Date | 2025-12-03 |