| NPI | 1245445162 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: NY 257881-1) |
| Additional Taxonomies | 2083B0002X Preventive Medicine, Obesity Medicine (Licence: MI 87627915) |
| Enumeration Date | 2007-05-14 |
| Last Update Date | 2022-03-14 |