| NPI | 1659990521 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine (Licence: NJ NJDCATEMP-000734) |
| Enumeration Date | 2020-04-10 |
| Last Update Date | 2020-04-10 |