| NPI | 1811421357 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: FL OS16625) |
| Additional Taxonomies | 207QB0002X Family Medicine Obesity Medicine (Licence: FL OS16625) |
| Enumeration Date | 2017-04-11 |
| Last Update Date | 2024-10-22 |