| NPI | 1174669246 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL ME115384) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IN 01062240A) |
| 207QB0002X Family Medicine, Bariatric Medicine (Licence: FL ME115384) | |
| Enumeration Date | 2007-01-29 |
| Last Update Date | 2025-12-17 |