| NPI | 1225229917 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NE 16127) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: NE 16127) |
| Enumeration Date | 2007-08-07 |
| Last Update Date | 2007-08-08 |