| NPI | 1205839917 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207R00000X Internal Medicine (Licence: NY 153422) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: NY 153422) |
| Enumeration Date | 2005-05-27 |
| Last Update Date | 2025-09-11 |