| NPI | 1154400174 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine (Licence: CA CALIFORNIA A17260) |
| Enumeration Date | 2006-11-02 |
| Last Update Date | 2007-07-08 |