| NPI | 1063533545 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 209648) |
| Additional Taxonomies | 202C00000X Independent Medical Examiner (Licence: NY 209648) |
| 2083X0100X Preventive Medicine Occupational Medicine (Licence: NY 209648) | |
| Enumeration Date | 2007-04-03 |
| Last Update Date | 2010-06-28 |