| NPI | 1972676716 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NJ MB49659) |
| Additional Taxonomies | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: NJ MB49659) |
| Enumeration Date | 2006-11-17 |
| Last Update Date | 2025-09-11 |