| NPI | 1174622500 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 202D00000X Integrative Medicine (Licence: TN MD29494) |
| Additional Taxonomies | 2086X0206X Surgery, Surgical Oncology (Licence: TN MD29494) |
| Enumeration Date | 2006-09-22 |
| Last Update Date | 2026-01-11 |