| NPI | 1275753063 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2083P0500X Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine (Licence: NJ 25MA05227200) |
| Enumeration Date | 2007-04-26 |
| Last Update Date | 2013-03-11 |