| NPI | 1902861230 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QB0002X Family Medicine, Bariatric Medicine (Licence: PA OS010598L) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA OS010598L) |
| Enumeration Date | 2006-04-19 |
| Last Update Date | 2020-09-28 |