| NPI | 1578000519 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: NJ 25MA09991600) |
| Additional Taxonomies | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: NY 287060) |
| Enumeration Date | 2017-01-29 |
| Last Update Date | 2017-01-29 |