| NPI | 1649344532 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NM 91-137) |
| Additional Taxonomies | 175L00000X Homeopath (Licence: NM 91-137) |
| Enumeration Date | 2006-11-20 |
| Last Update Date | 2019-05-15 |