| NPI | 1164459178 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA A67586) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: CA A67586) |
| 207RI0008X Internal Medicine, Hepatology (Licence: CA A67586) | |
| Enumeration Date | 2006-06-26 |
| Last Update Date | 2008-01-29 |