| NPI | 1700871969 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QS1201X Family Medicine, Sleep Medicine (Licence: FL ME83356) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: FL ME83356) |
| 207QB0002X Family Medicine, Bariatric Medicine (Licence: FL ME83356) | |
| Enumeration Date | 2005-09-14 |
| Last Update Date | 2021-11-29 |