| NPI | 1023402492 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NV 17909) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: NV 17909) |
| Enumeration Date | 2015-03-24 |
| Last Update Date | 2023-08-15 |