| NPI | 1093945123 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine (Licence: NY 161471) |
| Additional Taxonomies | 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine (Licence: NJ 25MA04562700) |
| Enumeration Date | 2009-07-23 |
| Last Update Date | 2012-05-16 |