| NPI | 1770580052 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083T0002X Preventive Medicine, Medical Toxicology (Licence: TN DO0000001613) |
| Additional Taxonomies | 173000000X Legal Medicine (Licence: TN DO1613) |
| 207QB0002X Family Medicine, Bariatric Medicine (Licence: TN DO0000001613) | |
| Enumeration Date | 2005-07-01 |
| Last Update Date | 2013-08-22 |