| NPI | 1548375785 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 240970) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: CT 044608) |
| 2083B0002X Preventive Medicine, Obesity Medicine (Licence: NY 240970) | |
| Enumeration Date | 2006-08-20 |
| Last Update Date | 2016-02-25 |