| NPI | 1669652335 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RB0002X Internal Medicine, Bariatric Medicine (Licence: CO 48205) |
| Additional Taxonomies | 208600000X Surgery (Licence: NY 232755) |
| 208600000X Surgery (Licence: CO 48205) | |
| Enumeration Date | 2007-11-09 |
| Last Update Date | 2021-11-12 |