| NPI | 1578584595 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 202D00000X Integrative Medicine (Licence: MO 2023041655) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: LA 14034r) |
| Enumeration Date | 2006-07-23 |
| Last Update Date | 2025-04-30 |