| NPI | 1497044895 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: VA 0102204155) |
| Additional Taxonomies | 207QB0002X Family Medicine, Bariatric Medicine (Licence: MD h77620) |
| 207Q00000X Family Medicine (Licence: MD H77620) | |
| Enumeration Date | 2011-04-06 |
| Last Update Date | 2026-04-17 |