| NPI | 1669433850 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: PA MD-037485-E) |
| Additional Taxonomies | 2083P0500X Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine (Licence: FL ME-89764) |
| 207Q00000X Family Medicine (Licence: PA MD-037485-E) | |
| 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: FL ME-89764) | |
| 207PE0004X Emergency Medicine, Emergency Medical Services (Licence: PA MD-037485-E) | |
| 207Q00000X Family Medicine (Licence: FL ME-89764) | |
| Enumeration Date | 2006-03-29 |
| Last Update Date | 2020-04-07 |