| NPI | 1922678697 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA A183212) |
| Additional Taxonomies | 2083B0002X Preventive Medicine, Obesity Medicine (Licence: CA A183212) |
| Enumeration Date | 2021-06-25 |
| Last Update Date | 2026-06-04 |