| NPI | 1447603659 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208D00000X General Practice (Licence: TX Q9070) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: TX Q9070) |
| 207Q00000X Family Medicine (Licence: TX Q9070) | |
| 2083B0002X Preventive Medicine Obesity Medicine (Licence: TX Q9070) | |
| Enumeration Date | 2016-07-22 |
| Last Update Date | 2019-02-07 |