| NPI | 1164046280 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QB0002X Family Medicine, Bariatric Medicine (Licence: TX T2906) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX T2906) |
| 2083B0002X Preventive Medicine, Obesity Medicine (Licence: TX T2906) | |
| 390200000X Student in an Organized Health Care Education/Training Program (Licence: TX BP10071492) | |
| Enumeration Date | 2020-06-04 |
| Last Update Date | 2023-08-10 |