| NPI | 1780996793 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AR E-7271) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: AR E-7271) |
| 2083B0002X Preventive Medicine, Obesity Medicine (Licence: AR E-7271) | |
| Enumeration Date | 2010-07-07 |
| Last Update Date | 2019-06-19 |