| NPI | 1548401573 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: NY 171294) |
| Additional Taxonomies | 209800000X Legal Medicine (Licence: NY 171294) |
| Enumeration Date | 2009-03-21 |
| Last Update Date | 2021-12-20 |