| NPI | 1073041620 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: VA 0101272886) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WI 73100-20) |
| 207QB0002X Family Medicine, Bariatric Medicine (Licence: WI 73100-20) | |
| 207QD0401X (Licence: WI 73100-20) | |
| 207QB0505X (Licence: WI 73100-20) | |
| 2083B0002X Preventive Medicine, Obesity Medicine (Licence: WI 73100-20) | |
| Enumeration Date | 2017-05-26 |
| Last Update Date | 2026-08-03 |