| NPI | 1255497749 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083P0500X Preventive Medicine Preventive Medicine/Occupational Environmental Medicine (Licence: NY 60-212185) |
| Enumeration Date | 2006-12-29 |
| Last Update Date | 2007-07-08 |