| NPI | 1922396001 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: TX S6931) |
| Additional Taxonomies | 208M00000X Hospitalist (Licence: WI 62202 - 20) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: MN 60330) | |
| Enumeration Date | 2011-07-11 |
| Last Update Date | 2026-05-20 |