NPI | 1063979060 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2083A0300X Preventive Medicine, Addiction Medicine (Licence: AL 35882) |
Additional Taxonomies | 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine (Licence: AL 35882) |
2083B0002X Preventive Medicine, Obesity Medicine (Licence: AL 35882) | |
Enumeration Date | 2019-02-26 |
Last Update Date | 2023-05-11 |