| NPI | 1992871693 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208600000X Surgery (Licence: NC 2012-01414) |
| Additional Taxonomies | 207RB0002X Internal Medicine, Bariatric Medicine (Licence: NC 2012-01414) |
| 208600000X Surgery (Licence: PA MD428098) | |
| Enumeration Date | 2006-11-27 |
| Last Update Date | 2024-02-21 |