| NPI | 1821354069 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2083P0901X Preventive Medicine Public Health & General Preventive Medicine (Licence: WA MD60702359) |
| Additional Taxonomies | 2083P0901X Preventive Medicine Public Health & General Preventive Medicine (Licence: MI 4301103767) |
| 2083P0901X Preventive Medicine Public Health & General Preventive Medicine (Licence: AZ 51381) | |
| Enumeration Date | 2012-04-02 |
| Last Update Date | 2020-11-09 |