| NPI | 1174732291 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 207RB0002X Internal Medicine, Bariatric Medicine (Licence: TX N5895) | 
| Additional Taxonomies | 390200000X Student in an Organized Health Care Education/Training Program | 
| Enumeration Date | 2007-05-22 | 
| Last Update Date | 2025-09-29 |