| NPI | 1285736066 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | No |
| Primary Taxonomy | 207Q00000X Family Medicine (Licence: NY A206094) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: NY A206094) |
| Enumeration Date | 2006-09-02 |
| Last Update Date | 2016-01-21 |