NPI | 1699972083 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine (Licence: TX E2128) |
Additional Taxonomies | 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine (Licence: LA MD.012079) |
Enumeration Date | 2007-06-28 |
Last Update Date | 2017-07-14 |