| NPI | 1851852073 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: TX T5015) |
| Additional Taxonomies | 207QB0002X Family Medicine, Bariatric Medicine (Licence: TX T5015) |
| Enumeration Date | 2019-03-29 |
| Last Update Date | 2025-08-02 |