NPI | 1710326418 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2083P0500X Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine (Licence: NY 279197) |
Additional Taxonomies | 208D00000X General Practice (Licence: NY 279197) |
Enumeration Date | 2013-06-17 |
Last Update Date | 2025-01-30 |