| NPI | 1649209123 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 175L00000X Homeopath (Licence: CT 000248) |
| Additional Taxonomies | 207Q00000X Family Medicine (Licence: CT 000248) |
| Enumeration Date | 2006-06-30 |
| Last Update Date | 2013-08-09 |