| NPI | 1790846988 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine Gastroenterology (Licence: FL ME92069) |
| Additional Taxonomies | 207RI0008X Internal Medicine Hepatology (Licence: FL ME92069) |
| Enumeration Date | 2006-12-12 |
| Last Update Date | 2019-08-20 |