| NPI | 1265733984 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine (Licence: UT 155578-1205) |
| Additional Taxonomies | 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine (Licence: UT 1555781205) |
| Enumeration Date | 2010-11-11 |
| Last Update Date | 2010-11-11 |