| NPI | 1982646097 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208600000X Surgery (Licence: AZ 4275) |
| Additional Taxonomies | 207RB0002X Internal Medicine, Bariatric Medicine (Licence: AZ 4275) |
| Enumeration Date | 2006-06-12 |
| Last Update Date | 2023-08-17 |