| NPI | 1184852717 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208100000X Physical Medicine & Rehabilitation (Licence: TX H 6063) |
| Additional Taxonomies | 207QB0002X Family Medicine, Bariatric Medicine (Licence: TX H6063) |
| 207V00000X Obstetrics & Gynecology (Licence: TX H6063) | |
| Enumeration Date | 2009-06-22 |
| Last Update Date | 2013-05-06 |