NPI | 1205810058 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine (Licence: LA MD300343) |
Additional Taxonomies | 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine (Licence: TX G9651) |
Enumeration Date | 2005-12-05 |
Last Update Date | 2015-10-26 |