| NPI | 1215134325 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: MA 238929) |
| Additional Taxonomies | 207RB0002X Internal Medicine Obesity Medicine (Licence: MA 89997183) |
| 2083B0002X Preventive Medicine Obesity Medicine (Licence: MA 89997183) | |
| Enumeration Date | 2007-07-02 |
| Last Update Date | 2025-08-12 |