| NPI | 1558665398 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208D00000X General Practice (Licence: AZ 12665) |
| Additional Taxonomies | 207RB0002X Internal Medicine Obesity Medicine (Licence: AZ 12665) |
| 133NN1002X Nutritionist Nutrition, Education (Licence: AZ 12665) | |
| Enumeration Date | 2011-01-10 |
| Last Update Date | 2011-01-11 |