| NPI | 1306959465 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QB0002X Family Medicine, Bariatric Medicine (Licence: FL ME99872) |
| Additional Taxonomies | 208600000X Surgery (Licence: FL ME99872) |
| Enumeration Date | 2006-08-15 |
| Last Update Date | 2020-08-31 |