| 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 |