| NPI | 1518985746 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083T0002X Preventive Medicine, Medical Toxicology (Licence: TN 19701) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: NY 219852) |
| 207P00000X Emergency Medicine (Licence: TN 19701) | |
| 207PT0002X Emergency Medicine, Medical Toxicology (Licence: NY 219852) | |
| 2083P0500X Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine (Licence: NY 219852) | |
| 2083X0100X Preventive Medicine, Occupational Medicine (Licence: TN 19701) | |
| Enumeration Date | 2006-07-17 |
| Last Update Date | 2020-09-15 |