| NPI | 1508853219 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: GA 45711) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: GA 45711) |
| 207RB0002X Internal Medicine, Bariatric Medicine (Licence: GA 45711) | |
| 207RG0100X Internal Medicine, Gastroenterology (Licence: GA 45711) | |
| Enumeration Date | 2005-09-29 |
| Last Update Date | 2025-04-25 |