| NPI | 1700343993 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083P0500X Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine (Licence: NY 152671) |
| Enumeration Date | 2019-02-25 |
| Last Update Date | 2019-02-25 |