| NPI | 1518079722 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207RB0002X Internal Medicine, Bariatric Medicine (Licence: WA 89983087) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WA OP00001533) |
| Enumeration Date | 2006-09-01 |
| Last Update Date | 2018-08-15 |