| NPI | 1104246149 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207RE0101X Internal Medicine, Endocrinology, Diabetes & Metabolism (Licence: NJ 25MA10064000) |
| Additional Taxonomies | 207RB0002X Internal Medicine, Bariatric Medicine (Licence: NJ 25MA10064000) |
| 390200000X Student in an Organized Health Care Education/Training Program | |
| Enumeration Date | 2014-04-17 |
| Last Update Date | 2025-03-05 |