| NPI | 1043343056 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NH 17075) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: NH ACP069) |
| Enumeration Date | 2007-03-13 |
| Last Update Date | 2024-01-15 |