| NPI | 1770510083 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207VB0002X Obstetrics & Gynecology, Bariatric Medicine (Licence: TX L5839) |
| Additional Taxonomies | 174400000X Specialist (Licence: TX L5839) |
| Enumeration Date | 2006-06-26 |
| Last Update Date | 2016-07-11 |