| NPI | 1245673896 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: CA A160199) |
| Additional Taxonomies | 207RB0002X Internal Medicine, Bariatric Medicine (Licence: CA A160199) |
| Enumeration Date | 2013-04-14 |
| Last Update Date | 2022-06-28 |