| NPI | 1285919845 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2083P0901X Preventive Medicine Public Health & General Preventive Medicine (Licence: UT 164856-1205) |
| Additional Taxonomies | 2083P0901X Preventive Medicine Public Health & General Preventive Medicine (Licence: CA GFE47172) |
| Enumeration Date | 2011-10-14 |
| Last Update Date | 2011-10-14 |