| NPI | 1871904573 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MD D0086455) |
| Additional Taxonomies | 2083B0002X Preventive Medicine, Obesity Medicine (Licence: MD 89989475) |
| Enumeration Date | 2014-05-15 |
| Last Update Date | 2026-08-04 |