| NPI | 1003896523 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207QB0002X Family Medicine, Bariatric Medicine (Licence: PA OS016657) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: NJ 25MB07327000) |
| 207QB0002X Family Medicine, Bariatric Medicine (Licence: NJ 25MB07327000) | |
| Enumeration Date | 2006-01-19 |
| Last Update Date | 2023-04-19 |