NPI | 1720302722 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | Yes |
Primary Taxonomy | 173000000X Legal Medicine (Licence: NY 118615) |
Additional Taxonomies | 172V00000X Community Health Worker (Licence: NY 118615) |
Enumeration Date | 2010-03-18 |
Last Update Date | 2010-03-18 |