| NPI | 1184729253 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: AZ 63760) |
| Additional Taxonomies | 171100000X Acupuncturist |
| 207Q00000X Family Medicine (Licence: IL 036089784) | |
| Enumeration Date | 2006-09-14 |
| Last Update Date | 2024-09-17 |