| NPI | 1164714689 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: PA OS017209) |
| Additional Taxonomies | 208600000X Surgery (Licence: CA 20A13988) |
| 207RB0002X Internal Medicine, Bariatric Medicine (Licence: PA OS017209) | |
| Enumeration Date | 2011-05-03 |
| Last Update Date | 2016-08-11 |