| NPI | 1689886921 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: WA MD60338708) |
| Additional Taxonomies | 175L00000X Homeopath |
| 207Q00000X Family Medicine (Licence: NV 14179) | |
| Enumeration Date | 2007-05-07 |
| Last Update Date | 2016-06-17 |