| NPI | 1790165785 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA 20A16309) |
| Additional Taxonomies | 207QB0002X Family Medicine, Bariatric Medicine (Licence: CA 20A16309) |
| 207QS1201X Family Medicine, Sleep Medicine (Licence: CA 20A16309) | |
| Enumeration Date | 2015-06-04 |
| Last Update Date | 2024-11-05 |