| NPI | 1982707212 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: TX P1009) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: NY 235856) |
| Enumeration Date | 2006-09-05 |
| Last Update Date | 2024-04-19 |