NPI | 1255823993 |
---|---|
Entity Type | Individual |
Gender | Male |
Sole Proprietor ? | No |
Primary Taxonomy | 202D00000X Integrative Medicine (Licence: CA A164405) |
Additional Taxonomies | 207Q00000X Family Medicine (Licence: CA A164405) |
2083P0500X Preventive Medicine, Preventive Medicine/Occupational Environmental Medicine (Licence: CA A164405) | |
Enumeration Date | 2018-05-30 |
Last Update Date | 2024-01-19 |