| NPI | 1104230283 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: SC 37183) |
| Additional Taxonomies | 207VB0002X Obstetrics & Gynecology, Bariatric Medicine (Licence: SC 37183) |
| 208600000X Surgery (Licence: AL 411168) | |
| Enumeration Date | 2014-06-17 |
| Last Update Date | 2021-12-03 |