| NPI | 1487716411 | 
|---|---|
| Entity Type | Individual | 
| Gender | Male | 
| Sole Proprietor ? | No | 
| Primary Taxonomy | 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine (Licence: CA C54234)  | 
| Additional Taxonomies | 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine (Licence: NC 36162)  | 
| 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine (Licence: FL ME 79276)  | |
| 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine (Licence: NV 14424)  | |
| Enumeration Date | 2006-12-15 | 
| Last Update Date | 2019-09-23 |