| NPI | 1992799514 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NV 15660) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA A61928) |
| 207Q00000X Family Medicine (Licence: NE 23273) | |
| 207QB0002X Family Medicine, Bariatric Medicine (Licence: NV 15660) | |
| Enumeration Date | 2005-09-09 |
| Last Update Date | 2023-08-09 |