| NPI | 1710955638 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: PA MD072095L) |
| Additional Taxonomies | 207RB0002X Internal Medicine, Bariatric Medicine (Licence: PA MD072095L) |
| 2083P0011X Preventive Medicine, Undersea and Hyperbaric Medicine (Licence: PA md072095L) | |
| Enumeration Date | 2006-03-08 |
| Last Update Date | 2022-06-09 |