| NPI | 1669467395 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RB0002X Internal Medicine, Bariatric Medicine (Licence: TX G1407) | 
| Additional Taxonomies | 174400000X Specialist (Licence: TX G1407) | 
| Enumeration Date | 2005-09-19 | 
| Last Update Date | 2022-09-08 |