| NPI | 1689196891 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083B0002X Preventive Medicine, Obesity Medicine (Licence: AZ 008629) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: MI 5101023638) |
| Enumeration Date | 2017-07-10 |
| Last Update Date | 2024-03-14 |