| NPI | 1104853936 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MS 13184) |
| Additional Taxonomies | 207QB0002X Family Medicine, Bariatric Medicine (Licence: MS 13184) |
| 2083B0002X Preventive Medicine, Obesity Medicine (Licence: MS 13184) | |
| Enumeration Date | 2006-06-27 |
| Last Update Date | 2025-07-10 |