| NPI | 1922260017 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: TX P9083) |
| Additional Taxonomies | 207RI0008X Internal Medicine, Hepatology (Licence: PA MD439721) |
| 207R00000X Internal Medicine (Licence: OH 35.093170) | |
| Enumeration Date | 2008-06-30 |
| Last Update Date | 2015-11-02 |