| NPI | 1659369908 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2083P0500X Preventive Medicine Preventive Medicine/Occupational Environmental Medicine (Licence: NY 203721) |
| Enumeration Date | 2005-10-11 |
| Last Update Date | 2013-11-18 |