| NPI | 1144462797 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QB0002X Family Medicine, Bariatric Medicine (Licence: KY 45197) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: IN 01078543A) |
| Enumeration Date | 2009-03-28 |
| Last Update Date | 2025-10-23 |