| NPI | 1760461719 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: CA G39186) | 
| Additional Taxonomies | 207RI0008X Internal Medicine, Hepatology (Licence: CA G39186) | 
| Enumeration Date | 2006-01-10 | 
| Last Update Date | 2010-08-02 |