| NPI | 1598258154 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA 20A17804) |
| Additional Taxonomies | 207QB0002X Family Medicine, Bariatric Medicine (Licence: CA 20A17804) |
| Enumeration Date | 2018-06-08 |
| Last Update Date | 2024-04-17 |