| NPI | 1467071217 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207QB0002X Family Medicine, Bariatric Medicine (Licence: PA md456458) |
| Additional Taxonomies | 207QB0002X Family Medicine, Bariatric Medicine (Licence: PA MD486458) |
| 207Q00000X Family Medicine (Licence: NJ 25ma11628700) | |
| Enumeration Date | 2020-04-13 |
| Last Update Date | 2024-11-19 |