| NPI | 1467433078 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083X0100X Preventive Medicine Occupational Medicine (Licence: NY 135044) |
| Additional Taxonomies | 208600000X Surgery (Licence: NY 135044) |
| Enumeration Date | 2005-11-10 |
| Last Update Date | 2011-11-19 |