| NPI | 1982109740 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QA0401X Family Medicine, Addiction Medicine (Licence: NY 312837) |
| Additional Taxonomies | 2083B0002X Preventive Medicine, Obesity Medicine (Licence: NY 312837) |
| 207Q00000X Family Medicine (Licence: NY 312837) | |
| 2083B0002X Preventive Medicine, Obesity Medicine (Licence: CA A163513) | |
| 207QB0002X Family Medicine, Bariatric Medicine (Licence: NY 312837) | |
| 207Q00000X Family Medicine (Licence: CA A163513) | |
| 207QA0401X Family Medicine, Addiction Medicine (Licence: CA A163513) | |
| 207QB0002X Family Medicine, Bariatric Medicine (Licence: CA A163513) | |
| Enumeration Date | 2018-03-26 |
| Last Update Date | 2025-11-22 |