| NPI | 1922260017 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | Yes | 
| Primary Taxonomy | 207RG0100X Internal Medicine, Gastroenterology (Licence: TX P9083)  | 
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35.093170)  | 
| 207RI0008X Internal Medicine, Hepatology (Licence: PA MD439721)  | |
| Enumeration Date | 2008-06-30 | 
| Last Update Date | 2025-02-05 |