| NPI | 1972544013 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QB0002X Family Medicine, Bariatric Medicine (Licence: OH 35.084556) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: OH 35084556B) |
| Enumeration Date | 2006-06-09 |
| Last Update Date | 2021-12-22 |