| NPI | 1962654681 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: UT 7148416-1205) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: UT 7148416-1205) |
| Enumeration Date | 2008-10-13 |
| Last Update Date | 2025-12-03 |