| NPI | 1952514655 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207QB0002X Family Medicine, Bariatric Medicine (Licence: PR 12461) |
| Additional Taxonomies | 208D00000X General Practice (Licence: PR 12461) |
| Enumeration Date | 2007-05-08 |
| Last Update Date | 2024-11-21 |