| NPI | 1588863492 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: NJ 25MA03606600) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NJ 25MA03606600) |
| Enumeration Date | 2007-07-12 |
| Last Update Date | 2007-07-12 |