| NPI | 1083653539 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: WA op00001972) |
| Additional Taxonomies | 207RB0002X Internal Medicine, Bariatric Medicine (Licence: WA OP00001972) |
| Enumeration Date | 2006-06-06 |
| Last Update Date | 2021-04-16 |