| NPI | 1326267147 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX N6542) |
| Additional Taxonomies | 133VN1201X Dietitian, Registered, Nutrition, Obesity and Weight Management (Licence: TX N6542) |
| 208600000X Surgery (Licence: TX N6542) | |
| Enumeration Date | 2007-04-24 |
| Last Update Date | 2025-04-07 |