NPI | 1144396656 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2083P0500X Preventive Medicine Preventive Medicine/Occupational Environmental Medicine (Licence: NY 175278-1) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: NY 175278-1) |
Enumeration Date | 2006-11-27 |
Last Update Date | 2023-03-07 |