NPI | 1255385068 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207RB0002X Internal Medicine, Bariatric Medicine (Licence: NC 19891) |
Additional Taxonomies | 207QB0002X Family Medicine, Bariatric Medicine (Licence: NC 19891) |
208000000X Pediatrics (Licence: NC 19891) | |
207Q00000X Family Medicine (Licence: NC 19891) | |
Enumeration Date | 2006-05-19 |
Last Update Date | 2024-03-08 |