| NPI | 1487090858 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2083B0002X Preventive Medicine, Obesity Medicine (Licence: MO 2022034246) |
| Additional Taxonomies | 208600000X Surgery (Licence: MO 2022034246) |
| Enumeration Date | 2013-05-13 |
| Last Update Date | 2026-09-28 |