| NPI | 1477693323 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: MN 53501) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 183882-1) |
| 2083P0500X Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine (Licence: MN 53501) | |
| 2083P0500X Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine (Licence: NY 183882-1) | |
| Enumeration Date | 2007-02-08 |
| Last Update Date | 2018-01-30 |