| NPI | 1558318121 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: OH 35.092695) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 275495) |
| 2083X0100X Preventive Medicine, Occupational Medicine (Licence: OH 35.092695) | |
| 2083X0100X Preventive Medicine, Occupational Medicine (Licence: NY 275495) | |
| Enumeration Date | 2006-05-28 |
| Last Update Date | 2022-08-26 |