| NPI | 1548979404 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2083P0500X Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine (Licence: NY 168917) |
| Enumeration Date | 2022-11-21 |
| Last Update Date | 2022-11-21 |