NPI | 1629164447 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine (Licence: DE C1-0008620) |
Additional Taxonomies | 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine (Licence: GA 62171) |
2083P0901X Preventive Medicine, Public Health & General Preventive Medicine (Licence: NJ 25MA09423100) | |
Enumeration Date | 2006-10-05 |
Last Update Date | 2017-08-18 |