| NPI | 1295176675 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX T3114) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: IL 036-139087) |
| 2083B0002X Preventive Medicine, Obesity Medicine (Licence: TX T3114) | |
| Enumeration Date | 2013-07-12 |
| Last Update Date | 2022-03-28 |