| NPI | 1598050783 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083B0002X Preventive Medicine, Obesity Medicine (Licence: MN 55269) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MN 55269) |
| Enumeration Date | 2011-06-15 |
| Last Update Date | 2025-05-09 |