| NPI | 1790760049 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207L00000X Anesthesiology (Licence: MD D54682) |
| Additional Taxonomies | 207L00000X Anesthesiology (Licence: MD D0054682) |
| 207RB0002X Internal Medicine, Bariatric Medicine (Licence: MD D54682) | |
| Enumeration Date | 2005-12-09 |
| Last Update Date | 2022-07-03 |