| NPI | 1538256201 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: NY 230211) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 35-088528) |
| 207R00000X Internal Medicine (Licence: OH 35-088528) | |
| 2083X0100X Preventive Medicine, Occupational Medicine (Licence: KY 43149) | |
| Enumeration Date | 2006-10-06 |
| Last Update Date | 2021-10-25 |