| NPI | 1609919711 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RB0002X Internal Medicine, Bariatric Medicine (Licence: FL ME-84580) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: FL ME 84580) |
| Enumeration Date | 2007-02-15 |
| Last Update Date | 2007-10-22 |