| NPI | 1710264056 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083P0500X Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine (Licence: NY 199427) |
| Additional Taxonomies | 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine (Licence: NY 199437) |
| 2083X0100X Preventive Medicine, Occupational Medicine (Licence: NY 199437) | |
| Enumeration Date | 2011-11-15 |
| Last Update Date | 2023-03-07 |