NPI | 1023422607 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 207QB0002X Family Medicine, Bariatric Medicine (Licence: MA 270162) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: RI MD17833) |
207Q00000X Family Medicine (Licence: MA 270162) | |
Enumeration Date | 2014-06-11 |
Last Update Date | 2022-03-10 |