| NPI | 1780003442 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine (Licence: CO DR.0057889) |
| Additional Taxonomies | 2083P0901X Preventive Medicine, Public Health & General Preventive Medicine (Licence: NM DO2025-0114) |
| Enumeration Date | 2014-04-09 |
| Last Update Date | 2025-09-15 |