| NPI | 1942465299 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: FL ME132015) |
| Additional Taxonomies | 2083X0100X Preventive Medicine, Occupational Medicine (Licence: CA A111074) |
| 202D00000X Integrative Medicine (Licence: FL ME132015) | |
| Enumeration Date | 2008-07-26 |
| Last Update Date | 2025-12-01 |