| NPI | 1891742953 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 202D00000X Integrative Medicine (Licence: VA 0101279488) |
| Additional Taxonomies | 207P00000X Emergency Medicine (Licence: DC MD038463) |
| 207P00000X Emergency Medicine (Licence: PA MD424508) | |
| Enumeration Date | 2006-05-27 |
| Last Update Date | 2025-02-16 |