| NPI | 1831314210 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NJ 25MA03349600) |
| Additional Taxonomies | 2083X0100X Preventive Medicine Occupational Medicine (Licence: NJ 25MA03349600) |
| 2083X0100X Preventive Medicine Occupational Medicine (Licence: NY 164291) | |
| Enumeration Date | 2007-04-13 |
| Last Update Date | 2007-07-09 |