| NPI | 1295065944 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2083X0100X Preventive Medicine Occupational Medicine (Licence: OH 35-071338) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 161403) |
| 2083X0100X Preventive Medicine Occupational Medicine (Licence: NJ 25MA05782700) | |
| Enumeration Date | 2009-12-31 |
| Last Update Date | 2009-12-31 |