| NPI | 1609914290 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA 20A8382) |
| Additional Taxonomies | 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine (Licence: CA 20A8382) |
| 207QB0002X Family Medicine, Bariatric Medicine (Licence: CA 20A8382) | |
| Enumeration Date | 2007-02-03 |
| Last Update Date | 2009-03-18 |