| NPI | 1780661835 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 202D00000X Integrative Medicine (Licence: OH 34008419) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: OH 34008419) |
| Enumeration Date | 2005-12-29 |
| Last Update Date | 2025-06-05 |