NPI | 1528322609 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine (Licence: MD D0047021) |
Additional Taxonomies | 208D00000X General Practice (Licence: MD D47021) |
Enumeration Date | 2012-07-03 |
Last Update Date | 2012-07-03 |