| NPI | 1215680509 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: PR 023121) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: PR 827) |
| Enumeration Date | 2022-01-27 |
| Last Update Date | 2024-02-12 |