| NPI | 1821822198 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 363LF0000X Nurse Practitioner, Family (Licence: NE 115459) |
| Additional Taxonomies | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: NE 115459) |
| 2083B0002X Preventive Medicine, Obesity Medicine (Licence: NE 115459) | |
| 208D00000X General Practice (Licence: NE 115459) | |
| Enumeration Date | 2024-08-29 |
| Last Update Date | 2024-11-06 |