| NPI | 1497720270 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: NY 187118-1) |
| Additional Taxonomies | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: PA MD044017L) |
| Enumeration Date | 2006-02-23 |
| Last Update Date | 2021-03-09 |