| NPI | 1689020968 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine (Licence: OR MD24847) |
| Additional Taxonomies | 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine (Licence: WA MD00033417) |
| 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine (Licence: CA G58387) | |
| Enumeration Date | 2016-05-05 |
| Last Update Date | 2016-05-05 |