| NPI | 1467780494 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | ANDREW LLOYD NELSON Owner 347-334-1733 |
| Organization Subpart ? | No |
| Primary Taxonomy | 207RS0010X Internal Medicine, Sports Medicine (Licence: NJ 25MA06570700) |
| Enumeration Date | 2009-12-02 |
| Last Update Date | 2010-03-10 |