| NPI | 1730137829 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QB0002X Family Medicine, Bariatric Medicine (Licence: MN 44857) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MN 44857) |
| Enumeration Date | 2006-05-04 |
| Last Update Date | 2025-05-28 |