| NPI | 1285601963 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 197629) |
| Additional Taxonomies | 133N00000X Nutritionist (Licence: NY 197629) |
| Enumeration Date | 2006-03-02 |
| Last Update Date | 2023-05-03 |