| NPI | 1780655233 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 202D00000X Integrative Medicine (Licence: CA C198282) |
| Additional Taxonomies | 207R00000X Internal Medicine (Licence: NY 220549) |
| Enumeration Date | 2006-01-31 |
| Last Update Date | 2025-02-24 |