| NPI | 1609837194 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: ME MD29585) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: WV 21899) |
| 207QB0002X Family Medicine, Bariatric Medicine (Licence: ME MD29585) | |
| Enumeration Date | 2006-04-01 |
| Last Update Date | 2026-02-03 |