| NPI | 1275866519 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: CA C33586) |
| Additional Taxonomies | 207RB0002X Internal Medicine Obesity Medicine (Licence: CA C33586) |
| 207RG0300X Internal Medicine Geriatric Medicine (Licence: CA C33586) | |
| Enumeration Date | 2009-09-17 |
| Last Update Date | 2009-09-17 |