| NPI | 1396817250 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2083P0901X Preventive Medicine Public Health & General Preventive Medicine (Licence: TX E-8539) |
| Additional Taxonomies | 2083P0901X Preventive Medicine Public Health & General Preventive Medicine (Licence: CA C-38229) |
| 2083P0901X Preventive Medicine Public Health & General Preventive Medicine (Licence: FL ME0032758) | |
| Enumeration Date | 2006-11-15 |
| Last Update Date | 2014-11-24 |