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 |