| 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 |