| NPI | 1013379791 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 309005) |
| Additional Taxonomies | 2083P0500X Preventive Medicine Preventive Medicine/Occupational Environmental Medicine (Licence: NJ 25MA11105000) |
| Enumeration Date | 2016-03-22 |
| Last Update Date | 2023-12-02 |