| NPI | 1790165785 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207QS1201X Family Medicine Sleep Medicine (Licence: CA 20A16309) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA 20A16309) |
| 207QB0002X Family Medicine Obesity Medicine (Licence: CA 20A16309) | |
| Enumeration Date | 2015-06-04 |
| Last Update Date | 2025-06-22 |