| NPI | 1639143480 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207RI0008X Internal Medicine, Hepatology (Licence: PR 9101) | 
| Additional Taxonomies | 207RG0100X Internal Medicine, Gastroenterology (Licence: PR 9101) | 
| Enumeration Date | 2006-02-16 | 
| Last Update Date | 2017-03-08 |