| NPI | 1033368212 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine (Licence: NJ 25MA03855200) |
| Additional Taxonomies | 133N00000X Nutritionist (Licence: NJ 25MA03855200) |
| 207RB0002X Internal Medicine, Bariatric Medicine (Licence: NJ 25MA03855200) | |
| Enumeration Date | 2008-09-12 |
| Last Update Date | 2008-09-12 |