| NPI | 1063473742 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 174494) |
| Additional Taxonomies | 2083A0100X Preventive Medicine, Aerospace Medicine (Licence: NY 174494) |
| Enumeration Date | 2006-03-31 |
| Last Update Date | 2010-04-09 |