| NPI | 1598100844 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QB0002X Family Medicine, Bariatric Medicine (Licence: UT 9738463-1204) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: UT 9738463-1204) |
| Enumeration Date | 2013-04-30 |
| Last Update Date | 2021-05-27 |