| NPI | 1407981426 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine (Licence: VA 0101248571) |
| Additional Taxonomies | 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine (Licence: LA MD.200619) |
| Enumeration Date | 2007-02-22 |
| Last Update Date | 2010-12-28 |