| NPI | 1710910914 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AK 1073) |
| Additional Taxonomies | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: AK 1073) |
| 207RB0002X Internal Medicine, Bariatric Medicine (Licence: AK 1073) | |
| Enumeration Date | 2006-07-09 |
| Last Update Date | 2010-10-21 |