| NPI | 1407996820 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207P00000X Emergency Medicine (Licence: NY 129824) |
| Additional Taxonomies | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: NY 129824) |
| Enumeration Date | 2007-02-07 |
| Last Update Date | 2013-11-06 |