| NPI | 1770950644 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OH 35.144573) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 295228) |
| 207RB0002X Internal Medicine, Bariatric Medicine (Licence: NY 295228) | |
| Enumeration Date | 2015-08-27 |
| Last Update Date | 2023-10-19 |