| NPI | 1225354947 |
|---|---|
| Former Name | NATHAN GEORGE WAIBEL |
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: MN 54310) |
| Additional Taxonomies | 207QS0010X Family Medicine, Sports Medicine (Licence: MN 54310) |
| Enumeration Date | 2010-04-20 |
| Last Update Date | 2021-09-20 |