| NPI | 1346878261 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: GA 96937) |
| Additional Taxonomies | 2083B0002X Preventive Medicine, Obesity Medicine (Licence: GA 96937) |
| Enumeration Date | 2020-03-27 |
| Last Update Date | 2026-05-07 |