| NPI | 1326037482 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QB0002X Family Medicine, Bariatric Medicine (Licence: PA OS006930L) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA OS006930L) |
| Enumeration Date | 2005-10-20 |
| Last Update Date | 2016-08-22 |