| NPI | 1457748766 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: NY 295009-1) |
| Additional Taxonomies | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: PA OS019490) |
| 2083X0100X Preventive Medicine, Occupational Medicine (Licence: NY 295009) | |
| Enumeration Date | 2015-04-24 |
| Last Update Date | 2021-03-23 |