| NPI | 1972759173 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MI 4301092311) |
| Additional Taxonomies | 207RG0100X Internal Medicine Gastroenterology (Licence: OK 1) |
| 207RI0008X Internal Medicine Hepatology (Licence: OK 2) | |
| Enumeration Date | 2008-08-07 |
| Last Update Date | 2019-07-05 |