| NPI | 1265548606 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 208D00000X General Practice (Licence: PR 9191) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: PR 9191) |
| Enumeration Date | 2006-08-21 |
| Last Update Date | 2007-07-08 |