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 |