| NPI | 1851365365 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 2083P0901X Preventive Medicine Public Health & General Preventive Medicine (Licence: GA 69300) |
| Additional Taxonomies | 2083P0901X Preventive Medicine Public Health & General Preventive Medicine (Licence: VA 0101222437) |
| Enumeration Date | 2006-02-14 |
| Last Update Date | 2018-09-06 |