NPI | 1467071217 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 207Q00000X Family Medicine (Licence: PA MD486458) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: NJ 25ma11628700) |
207QB0002X Family Medicine, Bariatric Medicine (Licence: PA MD486458) | |
207QB0002X Family Medicine, Bariatric Medicine (Licence: PA md456458) | |
Enumeration Date | 2020-04-13 |
Last Update Date | 2025-08-25 |