| NPI | 1639137169 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207N00000X Dermatology (Licence: FL me81131) |
| Additional Taxonomies | 2083B0002X Preventive Medicine, Obesity Medicine (Licence: FL ME81131) |
| Enumeration Date | 2006-05-03 |
| Last Update Date | 2025-03-18 |