| NPI | 1356547640 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: TX P3583) |
| Additional Taxonomies | 2083B0002X Preventive Medicine, Obesity Medicine (Licence: TX P3583) |
| Enumeration Date | 2007-06-22 |
| Last Update Date | 2025-08-23 |