| NPI | 1477523884 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083B0002X Preventive Medicine, Obesity Medicine (Licence: AK PADA978) |
| Additional Taxonomies | 363A00000X Physician Assistant |
| Enumeration Date | 2006-01-26 |
| Last Update Date | 2024-04-24 |