| NPI | 1225328099 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine (Licence: VA 0101247970) |
| Additional Taxonomies | 174400000X Specialist (Licence: VA 0101247970) |
| Enumeration Date | 2011-04-14 |
| Last Update Date | 2025-11-07 |