| NPI | 1740677145 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: HI MD-20151) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: MN 77088) |
| 2083B0002X Preventive Medicine, Obesity Medicine (Licence: NY 326397) | |
| 2083B0002X Preventive Medicine, Obesity Medicine (Licence: TX U7863) | |
| Enumeration Date | 2015-04-23 |
| Last Update Date | 2025-08-28 |