| NPI | 1124056494 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 174400000X Specialist (Licence: OR MD23347) |
| Additional Taxonomies | 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine (Licence: OR MD23347) |
| Enumeration Date | 2006-06-28 |
| Last Update Date | 2019-07-10 |