| NPI | 1750541991 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX N6425) |
| Additional Taxonomies | 2083B0002X Preventive Medicine, Obesity Medicine (Licence: TX N6425) |
| Enumeration Date | 2008-06-11 |
| Last Update Date | 2025-08-25 |