| NPI | 1760489918 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083P0901X Preventive Medicine Public Health & General Preventive Medicine (Licence: WA 025209 MD00025669) |
| Enumeration Date | 2005-07-01 |
| Last Update Date | 2008-03-28 |