| NPI | 1225480411 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: WA OP60842403) |
| Additional Taxonomies | 207RB0002X Internal Medicine, Bariatric Medicine (Licence: WA OP60842403) |
| Enumeration Date | 2016-07-12 |
| Last Update Date | 2025-12-15 |