NPI | 1942265111 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207QB0002X Family Medicine, Bariatric Medicine (Licence: PA MD043830E) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: PA MD043830-E) |
Enumeration Date | 2006-04-19 |
Last Update Date | 2020-04-30 |