| NPI | 1225177975 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine (Licence: VA 0101245896) |
| Additional Taxonomies | 251K00000X Public Health or Welfare (Licence: MI JP049321) |
| Enumeration Date | 2007-02-06 |
| Last Update Date | 2009-07-10 |