| NPI | 1962890038 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: MA 262055) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: MA 262053) |
| 207RB0002X Internal Medicine, Bariatric Medicine (Licence: MA 262055) | |
| Enumeration Date | 2014-12-24 |
| Last Update Date | 2021-08-20 |