| NPI | 1649255498 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: CA C142335) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: TX L1038) |
| 207QB0002X Family Medicine Obesity Medicine (Licence: CA C142335) | |
| Enumeration Date | 2005-12-14 |
| Last Update Date | 2025-06-24 |