| NPI | 1366741068 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QB0002X Family Medicine, Bariatric Medicine (Licence: GA 070518) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: GA 070518) |
| Enumeration Date | 2011-03-21 |
| Last Update Date | 2020-11-06 |