| 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 |