| NPI | 1952551608 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 2083P0901X Preventive Medicine Public Health & General Preventive Medicine (Licence: MD D17785(INACTIVE)) |
| Enumeration Date | 2008-09-30 |
| Last Update Date | 2008-09-30 |