| NPI | 1346643483 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2083P0901X Preventive Medicine Public Health & General Preventive Medicine (Licence: AZ 69019) |
| Additional Taxonomies | 2083P0901X Preventive Medicine Public Health & General Preventive Medicine (Licence: WI 75121-20) |
| Enumeration Date | 2014-10-03 |
| Last Update Date | 2023-12-05 |