| NPI | 1831203991 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: NY 162940) |
| Additional Taxonomies | 202C00000X Independent Medical Examiner (Licence: NY 162940-1) |
| 207R00000X Internal Medicine (Licence: NY 162940-1) | |
| Enumeration Date | 2006-08-18 |
| Last Update Date | 2012-08-17 |