NPI | 1659696425 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: CT 054311) |
Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 263739) |
Enumeration Date | 2010-04-05 |
Last Update Date | 2017-11-29 |