| NPI | 1952359135 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: TX H4879) |
| Additional Taxonomies | 174400000X Specialist (Licence: TX H4879) |
| Enumeration Date | 2006-05-04 |
| Last Update Date | 2024-11-19 |