| NPI | 1336110170 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WI 40389) |
| Additional Taxonomies | 207QB0002X Family Medicine, Bariatric Medicine (Licence: WI 40389-020) |
| Enumeration Date | 2006-01-30 |
| Last Update Date | 2016-07-11 |