| NPI | 1801987847 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QB0002X Family Medicine Obesity Medicine (Licence: VA 0102205019) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: KY 02885) |
| Enumeration Date | 2006-09-27 |
| Last Update Date | 2022-10-11 |