| NPI | 1629025895 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: OR MD210033) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: ID M-13587) |
| 207R00000X Internal Medicine (Licence: WA MD60511550) | |
| 207R00000X Internal Medicine (Licence: TX N4055) | |
| 207RB0002X Internal Medicine, Bariatric Medicine (Licence: WA MD60511550) | |
| Enumeration Date | 2006-05-31 |
| Last Update Date | 2023-12-29 |