| NPI | 1255414157 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: TX N0270) |
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: OH 35062919) |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: WV 16787) | |
| 207RI0008X Internal Medicine, Hepatology (Licence: OH 35062919) | |
| 207RI0008X Internal Medicine, Hepatology (Licence: WV 16787) | |
| Enumeration Date | 2006-10-23 |
| Last Update Date | 2022-07-07 |