| NPI | 1295838274 |
|---|---|
| Entity Type | Individual |
| Gender | Male |
| Sole Proprietor ? | Yes |
| Primary Taxonomy | 208000000X Pediatrics (Licence: NY 162989) |
| Additional Taxonomies | 171100000X Acupuncturist (Licence: NY 162989) |
| Enumeration Date | 2006-09-06 |
| Last Update Date | 2013-03-27 |